Abstract:Minimally invasive spinal surgery has become an important treatment for spinal diseases with the basic step of image-guid- ed puncture. The Image-guided equipment impacts the safety and accuracy of puncture position, thus affecting the treatment outcomes. The computed tomography (CT) guided technique takes the advantages of angle adjustment of CT frame and clear identification of various tis- sues. According to the purpose and location of surgery, the operation plane is determined, and then the surgical approach is precisely de- signed and quantified according to the principle of "the safest and simplest". The locating pin is punctured to the designed position accu- rately with simultaneous CT monitoring. CT guided technique has been successfully applied in percutaneous endoscopic discectomy, verte- broplasty, fracture internal fixation, percutaneous puncture biopsy, targeted therapy, and so on. Our department has successfully performed various CT-guided spinal minimally invasive surgeries nearly 10 000 cases, held more than 30 training sessions, involving a total of 600 do- mestic and foreign trainees, and has helped more than 100 hospitals inside and outside the province to carry out CT guided technique.

Abstract:[Objective] To search the factors related to early postoperative recurrence of lumbar disc herniation (LDH) secondary to per- cutaneous transforaminal endoscopic discectomy (PTED) . [Methods] A retrospective study was performed on 285 patients who received PT- ED for single-segment lumbar disc herniation from January 2017 to December 2019. The patients were divided into two groups according to whether the patients had early recurrent LDH after surgery, and the factors related to early recurrence were analyzed by univariate compari- son and binary multiple logistic regression. [Results] All the 285 patients were followed up for (12.64± 6.51) months on an average. Of them, 19 patients were definitively diagnosed of recurrent LDH within 6 months after operation, accounting for 6.67% with recurrence time of (73.53± 49.66) days on a mean. As results of univariate comparisons, the recurrent group had significantly more severer extent of disc degen- eration in Pfirrmann grade (P＜0.05) , more lateral protrusion (P＜0.05) , more severe Modic changes (P＜0.05) , lower intervertebral disc height index (P＜0.05) , greater width protrusion base (P＜0.05) , larger postoperative annular fibrous defect (P＜0.05) , whereas smaller inter- vertebral foramen area (P＜0.05) than the non-recurrent group. In term of logistic regression, the large width protrusion base (OR=1.368, P＜ 0.05) and severe Modic change (OR=1.761, P＜0.05) were of independent risk factors for early recurrence, while the large intervertebral fo- raminal area (OR=0.947, P＜0.05) was of a protective factor. [Conclusion] The small intervertebral disc height index, severe degree of inter- vertebral disc degeneration, large postoperative annulus fibrosus defect, more lateral protrusion site, large width of the protrusion base, and severe Modic change might be the risk factors, while large foraminal area be a protective factor for early recurrence after PTED.

Abstract:[Objective] To compare the effects of bone autograft composited with recombinant human bone morphogenetic protein-2 (rh- BMP-2) versus bone autograft only on posterior lumbar interbody fusion (PLIF) . [Methods] A retrospective study was conducted on 75 pa- tients who underwent PLIF for degenerative lumbar diseases in our department from January 2015 to August 2019. According to preopera- tive doctor-patient communication, 43 patients had PLIF performed with rhBMP-2 used (the BMP group) , while the remaining 32 patients were with bone autograft only (the BA group) . The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups were operated on successfully without serious complications. There was no significant difference in the time to resume full weight-bearing activity between the two groups (P＞0.05) . As time went during followed up lasted for (13.87±1.30) months, VAS, ODI and JOA scores in both groups significantly improved (P＜0.05) . At 6 months postoperatively, the BMP group proved significantly superior to the BA group in JOA score (P＜0.05) . Radiographically, the height of intervertebral space showed significant curve-like changes (P＜0.05) ; the Lenke grade for interbody fusion significantly improved in both groups (P＜0.05) ; whereas cage subsidence in term of Marchi’s criteria slightly increased in both groups regardless of no statistically significant differences among time points (P＞0.05) . At 3 months and 6 months the BMP group was significantly superior to the BA group in term of the height of intervertebral space (P＜0.05) . At 6 months and the last follow-up, the BMP group was significantly superior to the BA group in term of the Lenke grade of fusion (P＜0.05) , additionally, the former proved significantly superior to the latter in Marchi’s scale for cage subsidence at the last follow-up (P＜0.05) . [Conclusion] Bone autograft composited with rhBMP-2 does effectively reduce interbody non-fusion and cage subsidence in PLIF, and improve its clini- cal efficacy.

Abstract:[Objective] To compare the clinical outcomes of oblique lateral interbody fusion (OLIF) versus transforaminal lumbar inter- body fusion (TLIF) in the treatment of single-level specific lumbar intervertebral space infection. [Methods] A retrospective study was done on 45 patients who underwent surgical treatments for single-segment tuberculosis (TB) or brucellosis (Br) involving L₂ to L₄ in our hos- pital from August 2017 to August 2020. According to doctor-patient communication results, 20 patients received OLIF, while the other 25 patients received TLIF. The consequences regarding to perioperative period, follow-up, radiographic checks and laboratory tests were com- pared between the two groups. [Results] The OLIF group was significantly superior to TLIF group in terms of operation time, intraoperative blood loss, postoperative drainage and hospital stay (P<0.05) . All patients were followed up from 12 months to 24 months, and there was no statistical significance in the time to resume full weight-bearing activity between 2 groups (P>0.05) . The VAS and ODI scores decreased significantly in both groups over time (P<0.05) . Although there was no significant difference in VAS score between the two groups at the latest follow-up (P>0.05) , the OLIF group proved better than the TLIF group in term of ODI score (P<0.05) . The Frankel index for neuro- logical function significantly improved in both groups over time (P<0.05) , whereas with no statistically significant difference between the two groups at any corresponding time points (P>0.05) . With respect to imaging and laboratory examinations, the height of intervertebral space and lumbar lordotic angle significantly increased (P<0.05) , while CRP and ESR significantly decreased postoperatively compared with those preoperatively (P<0.05) . All patients in both groups achieved lesions subsided and bony fusion by the time of latest follow up. [Conclusion] The OLIF is safe and effective for treatment of single-level specific lumbar intervertebral space infection, with benefits of eas- ier to remove lesions, less trauma and better curative results in early and middle stage over the TLIF.

Abstract:[Objective] To explore the effect of platelet-rich plasma (PRP) in percutaneous transforaminal endoscopic discectomy (PT- ED) on clinical outcomes. [Methods] From January 2019 to December 2019, 73 patients underwent PTED fro simple lumbar disc hernia- tion. According to the preoperative doctor-patient communication results, 36 patients in PRP group were injected PRP 5ml combined with thrombin 2ml (40 U/ml) in intervertebral disc and around nerve roots at the end of surgery, while the other 37 patients in the non-PRP group had PTED performed alone. The Perioperative, follow-up and imaging data of the two groups were compared. [Results] All the pa- tients in both groups were successfully operated on, without significant difference in the incidence of intraoperative complications between the two groups (P=0.071) . There were no significant differences in operative time, total incision length, intraoperative blood loss, postoper- ative walking time, incision healing, hospital stay and early VAS score between 2 groups (P＞0.05) . With time of follow- up lasted for (15.37±1.92) months, the VAS and ODI scores decreased significantly in both group (P＜0.05) . However, the PRP group proved signifi- cantly superior to the non-PRP group in VAS score 1 month postoperatively (P＜0.05) , and the ODI score at 6 months and the last followup (P＜0.05) . Radiographically, the intervertebral height index decreased significantly over time in both groups (P＜0.05) , which in the PRP group was significantly superior to the non-PRP group at the last follow-up (P＜0.05) . No significant change was noted over time in term of Pfirrmann classification for disc degeneration between two groups (P＞0.05) . At the latest follow-up, the PRP group proved signifi- cantly superior to the non-PRP group in term of Pfirrmann grading of intervertebral discs degeneration (P＜0.05) . [Conclusion] Intraopera- tive injection of PRP in PTED might be beneficial to the repair of annulus fibrosus, delay intervertebral degeneration and improve clinical outcomes.

Abstract:[Objective] To compare the clinical outcomes of unilateral versus bilateral percutaneous kyphoplasty (PKP) for spinal metas- tases. [Methods] A retrospective study was conducted on 51 patients who received PKP for spinal metastasis complicated with pathological fracture in our hospital from April 2019 to April 2020. According to doctor-patient communication results, 28 patients underwent unilateral PKP, while the remaining 23 patients received bilateral PKP. The perioperative, follow-up and imaging data of the two groups were com- pared. [Results] All the 51 patients had PKP performed successfully without serious complications. Although there were no statistically sig- nificant differences between the two groups in terms of postoperative ambulation time and hospital stay (P＞0.05) , the unilateral group had significantly less intraoperative blood loss, whereas significantly higher bone cement leakage rate than the bilateral group (P＜0.05) . The op- eration time in unilateral group was significantly shorter than the bilateral group (P＜0.05) , the bone cement injection volume in bilateral group was significantly higher than the unilateral group (P＜0.05) . During the follow-up period lasted for more than 12 months, 9 patients developed similar fractures in the adjacent vertebral body, and 3 patients died due to the aggravation of the primary tumor. The VAS, ODI and KPS scores showed significant curve changes over time in both groups (P＜0.05) , however, there was no statistical significance in the abovementioned scores between the two groups at any corresponding time points (P＞0.05) . In terms of imaging evaluation, the unilateral group proved significantly inferior to the bilateral group in term of bone cement distribution (P＜0.05) . The height of injured vertebrae signif- icantly increased, while the local kyphosis angle significantly decreased postoperatively in both groups compared with those before surgery (P＜0.05) , whereas there was no statistical difference in the above imaging indicators between the two groups at any corresponding time points (P＞0.05) . [Conclusion] Both unilateral and bilateral PKP do effectively improve the quality of life for vertebral metastasis, by con- trast, the bilateral PKP reduce the risk of bone cement leakage, while improve the bone cement distribution in the vertebral body during oper- ation.

Abstract:Total hip arthroplasty (THA) has been successfully developed in the treatment of end- stage osteoarthritis of the hip. Ce- mented total hip arthroplasty was replaced by cementless total hip arthroplasty in the early 1980s due to the former’s complications associat- ed with periprosthetic osteolysis, implant loosening. Despite of the fact that cementless total hip arthroplasty has achieved excellent clinical results, thigh pain after cementless total hip arthroplasty is still a serious postoperative complication. The postoperative satisfaction and quality of life of patients were seriously impacted by thigh pain. However, little information about the etiology of thigh pain after cementless total hip arthroplasty is available. Data from mid-term and long-term follow-up studies suggest that thigh pain is related to the properties of the femoral stem. This review aims to review recent studies, summarize the factors that femoral stem associated with thigh pain after ce- mentless total hip arthroplasty, and analyze potential causes.

Abstract:Intervertebral disc degeneration (IVDD) is a chronic degenerative disease and prone to recurrence with high incidence and expensive treatment burden. Up to now the etiology and pathogenesis of IVDD remain unclear without effective treatment in some extent. Recent evidences show that in addition to abnormal and excessive mechanical load and inflammation, lipid metabolism disorder may be an important cause of IVDD. Beside the mechanical effect of body weight on intervertebral disc degeneration, adipokines, the lipid mediators derived from lipid metabolism disorders, including fatty acids, oxidized low-density lipoproteins and leptin, are closely related to IVDD. The purpose of this review is to summarize the latest findings on the relationship between lipid metabolism disorders and related products and their role in pathogenesis of IVDD, with particular emphasis on the role of lipids and adipokines and to explore the specific mechanism of intervertebral disc degeneration caused by lipid metabolism disorders.

Abstract:Dislocation of prosthesis is one of the common complications after total hip replacement, and still a major challenge for sur- geons. After the anterior dislocation of the prosthesis occurs, some doctors may even misjudge the posterior dislocation. In the closed reduc- tion process, the wrong direction of traction and reduction leads to the failure of manual reduction, even the fracture around the prosthesis and loosening of the prosthesis, with possibility of needing revision surgery. This article discusses the imaging evaluation, influencing fac- tors, correct preoperative planning and good postural management for anterior dislocation in order to provide references for clinical doctors to improve the curative outcomes of THA.

Abstract:Upper cervical cellular schwannoma is more likely to occur in the patients aged 40 to 50 years, but its incidence is extreme- ly low. The clinical symptoms are atypical with no obvious symptoms of spinal cord compression in the early stage, whereas often radicular irritation, and lack of obvious imaging features. This tumor is difficult to be distinguished from cervical spondylosis and malignant peripher- al nerve sheath tumors, prone to be misdiagnosed and mistreated. Once discovered, the disease should be surgically treated actively, which is the only and most effective treatment way currently. The surgical methods involve hemilaminectomy, en block vertebral resection, intra- capsular resection, and microsurgery techniques. The surgical consequences are usually good with satisfactory overall clinical outcomes. A reasonable surgical plan should be made based on various factors, such as different imaging manifestations, tumor invasion, functional needs, and stability after cervical surgery.

Abstract:[Objective] To explore the effects of intraarticular injection of anodonta glucan (HBP-A) in different dosages on cartilage de- generation of the knee, and related markers in guinea pigs. [Methods] Twenty guinea pigs were randomly divided into five groups, including the normal group, model group, low concentration group, medium concentration group and high concentration group, with 4 animals in each group. Four animals in the normal group were treated with right knee sham operation, while the remaining all animals were treated with ante- rior cruciate ligament transection of right knee to establish osteoarthritis (OA) model. Three days later, the normal group and model group were injected with normal saline into right knee joint, while the low, medium and high dose groups were injected with 7.5 mg/ml, 15 mg/ml and 30 mg/ml of HBP-A 200 μl, respectively, once a week for consecutive 5 weeks. Five weeks later, the animals were sacrificed, and the right knee samples were harvested for histological, immunohistochemical and qPCR assays. [Results] With histological observation, signifi- cant changes of cartilage degeneration were found in the model group compared with those in the normal group, whereas which significantly reversed in a dosage-dependent manner in the 3 groups with HBP-A in different dose. OARSI score in the model group was significantly higher than that of the normal group (P＜0.05) , which significantly decreased in a dose-dependent manner in the 3 HBP-A groups (P＜0.05) . In terms of immunohistochemistry, the optical density (OD) values of ALP, Ihh, Runx2 and MMP13 in the model group were significantly higher than those of the normal group (P＜0.05) , whereas which declined significantly in the 3 HBP groups in the dose-dependent manner (P＜0.05) . As results of qPCR assay, the mRNA relative expression levels of IL-1β, Ihh, Runx2 and MMP-13 in the model group were signif-icantly higher than those in the normal group (P＜0.05) , which also reduced significantly after injection of low, medium and high concentra- tions of HBP-A into the joint cavity in the dose-dependent manner (P＜0.05) . [Conclusion] In this study, intraarticular injection of HBP-A does reduce or delay the cartilage degeneration of the knee in guinea pigs.

Abstract:[Objective] To reveal the expression of leucine-rich repeat-containing protein 59 (LRRC59) in Ewing sarcoma and its effect on the prognosis of the patients. [Methods] Based on Gene expression data and clinical information of 56 Ewing sarcoma samples obtained from the International Cancer Genome Consortium (ICGC) database, Kaplan-Meier curve and univariate and multivariate Cox regression analysis were used to explore the relationship between LRRC59 expression and its prognosis. The biological function of LRRC59 was further evaluated by Gene Ontology (GO) analysis, while Connectivity Map (CMap) analysis was used to screen the drugs that might reverse the bio- logical effects of LRRC59. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression level of LRRC59 mRNA in Ewing sarcoma cells. [Results] The patients with high expression of LRRC59 survived significantly shorter (P=0.010) . The high expression of LRRC59 proved an independent risk factor predicting poor prognosis in patients with Ewing sarcoma (P＜0.05) . GO analysis showed that LRRC59 might be involved in regulating the formation of tumor cell focal adhesions and extracellular matrix. CMap analysis found that apigenin, quinostatin and other drugs had potential therapeutic effects on Ewing sarcoma. RT-qPCR further verified that the ex- pression of LRRC59 in Ewing sarcoma cells was higher than that in normal cells (P＜0.001) . [Conclusion] LRRC59 is an independent prog- nostic biomarker for Ewing sarcoma, which is expected to provide a novel therapeutic target for Ewing sarcoma.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of arthroscopic proximal lasso suture com- bined with calcaneal anchor for repair of acute closed Achilles tendon rupture. [Methods] From June 2018 to January 2019, 19 patients were treated with the above techniques for acute closed Achilles tendon rupture. Under arthroscope, the medial and lateral sides of the proximal Achilles tendon were sutured with 2# high-strength suture lasso, and the tail end of the suture was introduced to the two anchors 4.5mm in di- ameter on calcaneal tubercle under deep peritendinous membrane. The sutures were gradually tightened to pull the proximal end meet the dis- tal end of the tendon and fixed. [Results] All the 19 patients had operation performed successfully without serious complications such as neuro- vascular injury, and were followed up for more than 2 years. At the last follow-up, the ATRS score was of (96.89±4.17) . AOFAS ankle-hind- foot score of (96.11±5.02) , and the VAS score of (0.39±0.50) . All patients returned to their pre-injury level of physical activity about 6 months after surgery. [Conclusion] This arthroscopic technique for treatment of acute closed Achilles tendon rupture not only ensures the quality and strength of the tendon repair, but also avoid sural nerve injury to the maximum extent with satisfactory clinical outcomes.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of hip arthroscopy without a perineal post traction. [Methods] A total of 3 patients underwent hip arthroscopy without perineal post traction for acetabular impingement syndrome and glenoid labral injury by exploration and debridement, acetabulum and femoral head molding, and glenoid labral sutured. Without the perine- al post traction used during the operation, the patient was placed on the conventional traction table with 15° higher of the feet end than the head end. Combined with the methods of binding band fixation, the joint space was to open up by traction during the operation. The intraoper- ative fluoroscopy was used to verify the traction effect without additional material assistance. [Results] All the 3 patients had operation per- formed successfully without surgical complications, and were followed up for 1 week postoperatively. The VAS scores of the affected side sig- nificantly decreased postoperatively compared with that before operation. [Conclusion] This technique without perineal post traction does effectively solve the complications caused by perineal compression in hip arthroscopy with few requirements, and is easy to get started with good clinical application prospect.

Abstract:[Objective] To introduce the surgical techniques and preliminary clinical results of unilateral open-door laminoplasty com- bined with reattachment of posterior muscle for upper cervical ossification of posterior longitudinal ligament (OPLL) . [Methods] From March 2015 to March 2019, 16 patients with multiple levels of OPLL involving C₂ or upper underwent unilateral open-door laminoplasty combined with reattachment of posterior muscle. After exposing C_1~7 bilateral lamina and facets, the C_1~7 spine processes were removed with holes punched on base of C₄ and C₆. Bilateral bone slots on C_3~7 were made, with total bone removed on the right side, while outer bone corti- cal removed on the left side. Subsequently, the lamina in a whole was carefully raised on the right side about 1.5 cm, and fixed with mini tita- nium plate on C₃, C₅ and C₇, while suture tie on the C₄ and C₆. The C₂ total laminectomy was conducted, and bilateral pedicle screws were in- serted with a transvers plate fixed on the C₂. Finally, the posterior cervical muscle was sutured on the C₂ plate to reconstruct the attachment of the muscle. [Results] All the patients had operation performed successfully. At the latest follow up, the VAS and JOA scores significantly improved compared with those preoperatively (P＜0.05) , while the cervical range of motion remained unchanged significantly (P＞0.05) . [Conclusion] This unilateral open- door laminoplasty combined with reattachment of posterior muscle does effectively relieve the clinical symptoms, avoid postoperative head-up weakness, and achieve satisfactory clinical outcomes for upper cervical OPLL.

Abstract:[Objective] To investigate the clinical outcome of isthmic screw combined with non-fusion pedicle screw fixation for lumbar spondylolysis. [Methods] From January 2015 to June 2019, 21 patients underwent isthmic screw combined with non-fusion pedicle screw fixation for lumbar spondylolysis accompanied with or without grade I spondylolisthesis or discogenic low back pain. Clinical and imaging re- sults were observed. [Results] All the 21 patients had operation completed successfully, without neurovascular injury, cerebrospinal fluid leakage and other complication, while with operation time of (130.15±29.72) min and intraoperative blood loss of (215.64±58.51) ml on aver- age. With time of follow-up lasted for (32.62±9.43) months, the VAS and ODI scores significantly decreased (P＜0.05) . Radiographically, the fusion rate of isthmic defect was of 100% 18 months after operation, whereas no deterioration of adjacent-segment degeneration was no- ticed at the latest follow-up compared with that preoperatively in term of UCLA criteria. [Conclusion] Isthmic screw combined with non-fu- sion pedicle screw fixation is a safe and effective treatment for lumbar spondylolisthesis with or without grade I spondylolisthesis and disco- genic low back pain with a satisfactory fusion rate of the isthmic defect.

Abstract:[Objective] To investigate the clinical efficacy of pamidronate used for the treatment of osteofibrous dysplasia (OFD) . [Methods] A retrospective study was performed on 38 patients who received pamidronate intravenously for OFD in our department from Jan- uary 2011 to January 2021. [Results] Fever occurred in 1 patient at the time of first medication. Pathological fractures occurred in 5 patients during the treatment period, which in 4 patients underwent curettage, bone graft and internal fixation, while the other one received intramed- ullary nailing for internal fixation only. With time of follow- up lasted for 12~48 months with a mean of (30.79±13.03) months, the VAS scores decreased significantly (P<0.05) , while the SF-36 score increased significantly (P<0.05) ; in addition, serum C-terminal type I pro- collagen (C1NP) and serum N-terminal propeptide of type I procollagen (PINP) significantly decreased (P<0.05) , whereas the serum osteo- calcin remained unchanged (P<0.05) . Compared with that before treatment, the lesion area on radiographs reduced in 3 patients, remained unchanged in 32 patients, and enlarged in 3 patients at 6 months after treatment, whereas reduced in 7 patients, unchanged in 27 patients, and enlarged in 4 patients at the latest follow-up. [Conclusion] The pamidronate used for the treatment of OFD does relieve pain, decline bone metabolic markers and delay the progression of the disease with mild adverse reactions.

Abstract:[Objective] To investigate the clinical outcomes of cortical bone trajectory (CBT) screw fixation for adjacent segmental de- generation (ASD) secondary to lumbar instrumented fusion. [Methods] From March 2018 to March 2019, a total of 20 patients underwent CBT screw fixation for ASD after primary instrumented fusion in our department. The clinical and imaging documents were summarized. [Results] All the 20 patients were successfully operated on without serious complications such as vascular and nerve injury, while with operative time of (1.44±0.31) hours, the intraoperative blood loss of (248.27±16.51) ml, and the postoperative ambulation time of (7.23±1.12) days. The postoperative follow-up lasted for (14.62±5.84) months on an average, and the VAS score significantly decreased from (8.70±1.30) pre- operatively to (1.81±0.27) at the latest follow- up (P＜0.05) , the JOA score significantly increased from (12.04±1.31) before operation to (23.84±2.91) at the latest follow-up (P＜0.05) , whereas the ODI index significantly decreased from (18.14±6.42) % before operation to (3.74± 0.55) % at the last follow-up (P＜0.05) . By the time of the last follow-up, all 18 patients had obtained interbody fusion with the fusion time ranged from 6 to 9 months. [Conclusion] The CBT screw fixation does achieve good clinical outcomes for treatment of ASD after lumbar in- strumented fusion.

Abstract:[Objective] To evaluate the clinical efficacy of vertebroplasty combined with pedicle screw fixation for stage III Kümmell’s disease. [Methods] From 2016 to 2020, a total of 30 patients received vertebroplasty combined with pedicle screw fixation for stage III Kümmell’s disease. The clinical and imaging data were evaluated. [Results] All patients were successfully operated on with operation time of (1.31±0.34) hours, and intraoperative blood loss of (103.33±32.41) ml. After more than 24 months of follow-up, VAS and ODI scores de- creased significantly compared with those preoperatively (P＜0.05) . Radiographically, the anterior vertebral height of the involved vertebrae significantly increased (P＜0.05) , whereas the local kyphotic Cobb angle significantly decreased postoperatively compared with those preop- eratively (P＜0.05) . Compared with those at 2 weeks after surgery, the anterior vertebral height slightly decreased, while the local kyphosis Cobb angle increased at 24 months after surgery, which proved not statistically significant (P＞0.05) . At the latest follow-up, no bone cement displacement, internal fixation loosening or fracture were found in anyone of them. [Conclusion] The vertebroplasty combined with pedicle screw fixation does achieve satisfactory clinical results in the treatment of stage III Kümmell’s disease.

Abstract:[Objective] To evaluated the clinical outcomes of ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture. [Methods] A total of 66 patients (66 feet) received surgical repair of acute Achilles tendon rupture from 2017 to 2020. Based on pa- tient-doctor communication, 36 patients underwent ultrasound-assisted minimally invasive surgery (MI group) , while the remaining 30 pa- tients had the tendon repaired by conventional open surgery (CO group) . The documents of perioperative period and follow-up were com- pared between the two groups. [Results] The MI group proved significantly superior to the CO group in terms of operative time, incision length, hospital stay, intraoperative blood loss and postoperative walking time (P＜0.05) . Postoperative follow- up lasted for (12.34±3.45) months on a mean. The MI group resumed full weight bearing activity significant early than CO group (P＜0.05) . The VAS score significantly decreased (P＜0.05) , while AOFAS and ARTS scores, as well as range of motion (ROM) significantly increased in both groups over time (P＜ 0.05) , whereas which proved not statistically significant between the two groups at any matching time points (P＞0.05) . [Conclusion] Intra- operative ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture has the advantages of shortening operation time, re- ducing trauma, decreasing blood loss and improving postoperative recovery.