Abstract:Atlantoaxial dislocation (AAD) has been internationally regarded as the "surgical exclusion zone", with a very high mortali- ty. With the progress of modern surgical basic research and diagnosis and treatment technology, its clinical outcome is getting better and better. However, various anatomical variations and malformations of the skull base and upper cervical vertebrae, such as basilar invagina- tion combined with AAD, congenital atlantoaxial pedicle stenosis and high abnormal vertebral artery, increase the difficulty and risk of sur- gery. Another example is the clinical problem of medulla oblongata and upper cervical spinal cord injury caused by severe AAD compres- sion, which is still a challenge to modern medical treatment. To solve this clinical problem, individualized application of multiple stability reconstruction techniques is an effective solution. Multiple injuries and medical diseases are the main problems in the perioperative man- agement of atlantoaxial dislocation, while multidisciplinary team model is also an effective way to solve this problem. The academic view- point of "treating spinal diseases from the perspective of governor" and the treatment principle of "dredging the governor arteries by decom- pression of the spinal cord" also provide new ideas for exploring and solving the clinical difficulties of neurological function rehabilitation in spinal cord injury.

Abstract:[Objective] To evaluate the role of peripheral blood interleukin-6 (IL-6) predicting postoperative delirium (POD) after hip hemiarthroplasty by receiver operating characteristic (ROC) curve in elderly. [Methods] The aged patients who underwent hip hemiarthro- plasty in our hospital from January 2019 to June 2021 were included into this study. Confusion assessment method (CAM) was used to evalu- ate whether or not POD happened within 1 week after operation. The levels of IL-6 in peripheral venous blood were measured before surgery and at 1, 3, 5 and 7 days postoperatively. ROC curve analysis was conducted to evaluate the predictive value of IL-6 for POD. [Results] Of the 210 patients enrolled in this study, 30 patients developed POD, with an incidence of 14.29%. There was no significant difference in pe- ripheral blood IL-6 content between the groups before operation (P＞0.05) . However, the POD group had significantly higher blood IL-6 lev- els than the non-POD group at 1 and 3 days postoperatively (P＜0.05), which became not statistically significant between the two groups at 5 and 7 days after surgery (P＞0.05) . ROC curve analysis indicated that the area under curve (AUC) of IL-6 in peripheral blood at 1 d and 3 d after surgery for predicting postoperative delirium was 0.81 and 0.88, respectively, which had predictive value. [Conclusion] The incidence of postoperative delirium in elderly patients with hip hemiarthroplasty for femoral neck fracture is 14.29%. Monitoring the level of IL-6 in pe- ripheral blood in the first 3 days after surgery has high predictive value for postoperative delirium.

Abstract:[Objective] To investigate the safety and clinical outcomes of three-point reduction combined with percutaneous kyphoplas- ty (PKP) for thoracolumbar osteoporotic vertebral compression fracture (OVCF) complicated with posterior wall rupture. [Methods] A retro- spective study was done on 95 patients who received surgical treatment for OVCF in our hospital from January 2019 to October 2020. Based on preoperative radiographs, 12 patients were complicated with the posterior wall rupture (the rupture group) , while the remaining 83 pa- tients had no posterior wall rupture (non-rupture group) . All the patients in both groups were treated with three-point reduction, followed by PKP. The data regarding to perioperative period, follow-up and images were compared between the two groups. [Results] All the pa- tients in both groups had operation performed smoothly without serious complications. There were no significant differences between the two groups in terms of reduction time, operation time, fluoroscopy times, volume of bone cement injected, bone cement leakage, postopera- tive walking time and hospital stay (P＞0.05) . All of them in both groups were followed up for (15.03±6.77) months on an average, without a significant difference between the two groups in the time to resume full weight-bearing activity (P＞0.05) . The VAS and ODI scores signifi- cantly decreased in both groups over time (P＜0.05) , whereas which proved not statistically significant between the two groups at any match- ing time points (P＞0.05) . Radiographically, the anterior vertebral height significantly increased (P＜0.05) , whereas the local kyphotic Cobb angles significantly decreased in both groups postoperatively compared with those preoperatively (P＜0.05) . Although the rupture group had significantly lower anterior vertebral height than the non-rupture group preoperatively (P＜0.05) , there were no statistically significant dif- ferences in terms of anterior vertebral height and local kyphotic Cobb’s angle between the two groups postoperatively (P＞0.05) . [Conclusion] The three-point reduction combined with PKP is safe and effective for treatment of OVCF, especially complicated with posterior wall rupture, which restore the height of the vertebral body and relieve pain.

Abstract:[Objective] To compare the clinical outcomes of suture anchor versus cannulated screw for arthroscopic fixation of anterior cruciate ligament (ACL) tibial avulsion fractures. [Methods] A retrospective study was conducted on a total of 84 patients who underwent arthroscopic reduction and internal fixation of ACL tibial avulsion fracture in our hospital from June 2012 to June 2018. According to doc- tor-patient communication, 44 patients had fracture fixed with suture anchors (SA) , whereas the remaining 40 patients were fixed with can- nulated screws (CS) . The perioperative, follow-up and imaging results were compared between the two groups. [Results] All the 84 pa- tients had operation performed successfully without vascular or nerve injury. Although the SA group consumed significantly longer opera- tion time (P＜0.05) , whereas resumed walking postoperatively significant earlier than CS group (P＜0.05) , there was no significant differenc- es in the other perioperative parameters between them (P＞0.05) . All patients in the two groups were followed up for (25.18±4.53) months, and the SA group resumed full weight-bearing activity significantly earlier than CS group (P＜0.05) . The knees stability revealed by pivot shift test and Lachman test significantly improved in both groups postoperatively compared with those preoperatively (P＜0.05) , whereas which was not statistically significant between them at any matching time points (P＜0.05) . The Tegner, Lysholm, and IKDC scores in- creased significantly over time in both groups (P＜0.05) , which in the SA group proved significantly superior to the CS group at 3 months af- ter surgery (P＜0.05) , whereas became not statistically significant at 6 months postoperatively and at the latest follow-up (P＞0.05) . Radio- graphically, there was no significant difference in fracture reduction quality between the two groups (P＜0.05) , but the SA group got fracture healing on images significantly earlier than the CS group (P＜0.05) . In addition, there was no significant change in term of Kellgren-Law- rence grades for knee degeneration in both groups until the latest follow-up (P＞0.05) . [Conclusion] Both SA and CS fixation do effectively treat ACL tibial avulsion fracture, by contrast, SA has the advantages of facilitating fracture healing and providing better early clinical out-comes over the CS.

Abstract:[Objective] To compare the efficacy and safety of robot -assisted screw placement through intermuscular approach versus freehand screw placement in the fixation of cervical fracture and dislocation. [Methods] A retrospective study was done on 32 patients who received surgical treatment of cervical fracture and dislocation in our hospital from January 2016 to January 2020. According to the results of doctor- patient communication, 14 patients were treated with robot- assisted screw placement (the robot group) , while the other 18 cases were treated with traditional freehand screw placement (traditional group) . The perioperative period, follow-up and imaging consequences were compared between the two groups. [Results] All patients in both groups were operated on successfully with no serious complications. The robot group proved significantly superior to the traditional group in terms of operation time, intraoperative blood loss, fluoroscopy times, success rate of screw placement in the first time and hospital stay (P＜0.05) . All patients were followed up for an average of (27.35±4.37) months, and there was no significant difference in the time of resuming full weight-bearing activity between the two groups (P＞0.05) . The VAS scores were decreased significantly (P＜0.05) , while ASIA grade for neurological function and pyramidal tract sign were significantly im- proved in both groups over time (P＜0.05) . There was no significant difference in the above indexes between the two groups before operation (P＞0.05) . The robot group was significantly superior to the traditional group in VAS score at 3 months and 6 months after surgery (P＜0.05) , whereas which became not statistically significant between the two groups at the latest follow up (P＞0.05) . However, there were no signifi- cant differences in JOA score, ASIA grade and pyramidal tract sign between the two groups at any corresponding time points (P＞0.05) . In terms of imaging, the accuracy ratio of screw placement of the robot group was significantly better than that of the traditional group (P＜0.05) . There was no significant difference in bone fusion time between the two groups (P＞0.05) . Radiographically, thecervical curvature, segmental slip ratio and minimum sagittal diameter of spinal canal were significantly improved in both groups at last follow-up compared with those pre- operatively (P＜0.05) , which were not significantly different between the two groups at the two corresponding time points postoperatively (P＞ 0.05) . [Conclusion] Compared with free-hand screw placement, Tianji robot assisted screw placement does effectively shorten the opera- tion time, reduce surgical trauma, improve the accuracy of screw placement, and facilitate postoperative rehabilitation of patients..

Abstract:[Objective] To compare the clinical outcomes of posterior lumbar interbody fusion (PLIF) with or without preservation of the spinous process -ligament complex in the treatment of lumbar instability. [Methods] A retrospective study was conducted on a total of 84 pa- tients who received PLIF for lumbar instability in our hospital from February 2017 to December 2020. According to the results of preopera- tive doctor-patient communication, 42 patients had the spinous process-ligament complex preserved, while the remaining 42 patients had the spinous process-ligament complex removed routinely. The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] All patients in both groups had operation done successfully without serious complications. The preserved group proved significantly superior to the removed group in terms of intraoperative blood loss, postoperative drainage volume and VAS score of postoperative incision pain (P＜0.05) , although there was no significant difference in operation time and hospital stay between the two groups (P＞0.05) . The VAS scores of the low back pain and leg pain, ODI and JOA scores significantly improved in both groups over time (P＜0.05) . At latest follow-up, the preserved group was significantly superior to the removed group in VAS score of low back pain and JOA score (P＜0.05) , but there was no significant difference in VAS score of leg pain between the two groups (P＞0.05) . During the followup, postoperative persistent syndrome (POPS) did not occur in anyone of the preserved group, while which was of 8/42 (19.05%) in the re- moved group, with a statistically significant difference (P＜0.001) . Radiographically, the lumbar lordosis angle, intervertebral space height, and slippage percentage significantly improved in both groups at the latest follow-up compared with those before operation (P＜0.05) , addi- tionally, the Lenke fusion grade improved significantly over time in both groups (P＜0.05) . At the corresponding time points, there was no sig- nificant difference in the above imaging indexes between the two groups (P＞0.05) . [Conclusion] PLIFs with or without spinous process-lig-ament complex preservation are effective treatment of lumbar instability. By comparison, preservation of the complex is benefit to improve the long-term outcome.

Abstract:[Objective] To systematically evaluate the clinical efficacy of Femoral Neck System (FNS) for femoral neck fractures by comparison with cannulated screw (CS) . [Methods] The literatures on comparison of FNS and CS in the treatment of femoral neck fracture published from January 2017 to December 2021 were searched from the databases, including PubMed, CNKI, Cochrane Library, Wanfang, VIP database, Embase, CBM and ChiCTR. After quality assessment and data extraction performed independently by two researchers, the meta-analysis was performed using RevMan 5.4 software. [Results] A total of 9 retrospective cohort studies were included, involving 700 patients. As results of the meta-analysis, the FNS proved significantly superior to the CS for femoral neck fractures in terms of operation time (MD=-7.11, 95%CI -14.03~-0.20, P=0.04) , intraoperative fluoroscopy times (MD=-8.53, 95%CI -10.27~-6.78, P<0.001) , fracture healing time (MD=- 0.72, 95% CI-1.15~0.29, P=0.001) , hip function score 6 months after surgery (MD=4.10, 95% CI 1.88~6.32, P< 0.001) , femoral neck shortening rate (RR=0.63, 95%CI 0.47~0.83, P=0.009) , despite the former had greater intraoperative blood loss than the latter (MD=10.99, 95% CI 4.52~17.45, P=0.009) . However, there was no significant difference in the rate of femoral head necrosis (RR= 0.48, 95%CI 0.20~1.12, P=0.09) and the incidence of nonunion (RR=0.51, 95%CI 0.21~1.24, P=0.14) between the two groups. [Conclusion] FNS used for internal fixation of femoral neck fractures has advantages of shortening operation time, reducing intraoperative fluo- roscopy times, accelerating fracture healing, declining femoral neck shortening, and improving functional recovery, despite of the disadvan- tage of more intraoperative blood loss over the CS.

Abstract:The tibial transverse transport technique can induce the microvascular regeneration of diabetic foot by regulating the trans- ported bone fragments to promote ulcer healing and preserve limbs. In order to clarify the changes of foot microcirculation during transport, ultrasound is often used for monitoring in clinic. However, conventional ultrasound is often limited in observing the changes of the distal mi- crovessels of the whole part of diabetes foot and cannot detect the blood perfusion of microvessels in the distal extremity. The superb micro- vascular imaging is a new non-invasive blood flow imaging technology. Compared with conventional ultrasound technology, clinical studies have found that superb microvascular imaging can sensitively capture low-velocity blood flow, and has relative advantages in terms of micro- vascular disease, and micro-blood perfusion. This paper reviews the application status of superb microvascular imaging in the treatment of diabetic foot by tibial transverse transport.

Abstract:Total femoral replacement (TFR) is a salvage procedure for extensive femoral impairment, such as bone tumor invaded wide- ly, non-neoplastic disease with massive femoral bone defects secondary to pathological fracture, and revision of hip and knee arthroplasty with severe bone loss. With the rapid development of hip and knee arthroplasty, the number of revision arthroplasty due to trauma and infec- tion is increasing year by year, whereas the TFR is more and more used as a salvage measure in the revision of refractory prostheses loosen- ing with large bone defects, which get functional improvement in the most cases with low complications after surgery. In this paper, we report a case of TFR after multiple revisions of total hip arthroplasty, and review the published literature on TFR.

Abstract:Deep venous thrombosis (DVT) is a common and serious complication during the perioperative period of major arthroplasty. The intermittent pneumatic compression device (IPC) has been proved to reduce the risk and prevent lower extremity DVT during the perioper- ative period of joint replacement without increasing the incidence of pulmonary embolism events. However, there is no unified standard for the selection of IPC in terms of equipment type, use time, use frequency and strength during the perioperative period of joint replacement. This ar- ticle reviews the latest application status of IPC in the perioperative period of joint replacement to provide a reference for clinical work.

Abstract:We present an elderly patient who suffered from recurrent huge dumbbell-shaped schwannoma in upper thoracic spine in- volving the posterior mediastinum. The patient underwent the first surgical resection of intraspinal and foraminal masses to relieve spinal cord compression and promote neurological recovery. Forty-four months later, the patient had recurrent symptoms with posterior mediastinal mass growth, which was significantly larger than the previous one. Under general anesthesia, the second operation was performed, involving schwannoma resection, pedicle screw internal fixation and bone grafting through posterior midline approach. The tumor was completely re- sected and spinal stability was reconstructed. Based on the experience of this case, complete resection of the tumor by the posterior midline approach may be a safe procedure for partial dumbbell-shaped schwannomas involving the posterior mediastinum.

Abstract:[Objective] To explore the effect of microRNA (miR-210-3p) transfection in rat bone marrow mesenchymal stem cells (BMMSCs) on their osteogenic capacity. [Methods] Rat BMMSCs were isolated and cultured in vitro, and were randomly divided into 3 groups. The cells in the blank control group, MiR-210-3p enhanced group (enhanced group) and miR-210-3p inhibited group (inhibited group) were given transfection with the corresponding genes in vitro respectively. The cell biological behavious were detected, involving proliferation, apoptosis and migration, as well as osteogenic differentiation and adipogenic differentiation, in addition, qRT-PCR was used to detect mRNA expression levels of corresponding markers. [Results] The third generation BMMSCs obtained in this study were positive for CD44 and CD90, negative for CD34 and CD45, which were consistent with the surface antigen characteristics of mesenchymal stem cells. Compared with blank control group, mRNA expression of miR-210-3p in enhanced group was significantly increased (P＜0.05), whereas which in the inhibition group was significantly inhibited (P＜0.05). The OD value of cell proliferation, Transwell cell migration and alizarin red staining calcium deposition count were significantly ranked from high to low as the enhanced group ＞ blank control group＞inhibition group (P＜0.05). Conversely, the apoptosis rate and oil red O staining lipid drop count were significantly ranked from low to high as the enhanced group＜blank control group＜ inhibition group (P＜0.05), As results of qRT-PCR assay, the mRNA relative expression level of osteo-genic genes, including ALP and Bglap-2, was significantly ranked from high to low as the enhanced group＞blank control group＞inhibitiongroup (P＜0.05) , whereas the mRNA relative expression levels of lipid-expressing genes, including PPARγ and LPL, were from low to highas the enhanced group＜blank control group＜inhibition group (P＜0.05) . [Conclusion] In this study the miR-210-3p does promote osteogen-ic differentiation, inhibit adipogenic differentiation, reduce apoptosis, and promote cell proliferation and migration of BMMSCs in rats.

Abstract:[Objective] To investigate whether dithiothreitol (DTT) can improve the detection rate of pathogenic microorganisms in peri- prosthetic joint infection (PJI) secondary to joint replacement. [Methods] A prospective study was conducted on 46 patients who admitted to our department from March 2020 to October 2021 for chronic PJI. The tissue samples harvested from debridement were divided into 3 parts. One part was directly cultured for bacteria (direct group), the other part was soaked with normal saline for 15 minutes and then cultured with soaking solution (saline group) , while the last part was soaked with 1mg/ mL DTT solution for 15 minutes and then cultured with soaking so- lution (DTT group) . The bacterial culture results were compared among the three groups. [Results] The overall bacterial detection rate ranked up-down was 32/46 (69.57%) in DTT group, 20/46 (43.38%) in direct group and 17/46 (36.96%) in saline group, with a statistically significant difference among them (P<0.05) . In term of pairwise comparison, the DTT group had significantly higher detection rate than the direct group (P=0.011) and saline group (P=0.001) , nevertheless there was no significant difference between direct group and saline group (P=0.529) . A total of 69 bacterial strains were detected in 138 samples from 46 patients without significant differences in the detection rate of major bacterial species among the three sample treatments (P>0.05) . Among the 46 patients, the detection rate of 28 patients who were treated with antibiotics before surgery was 16/28 (57.14%) in the DTT group, 10/28 (35.71%) in the direct group and 8/28 (28.57%) in the sa- line group, with no statistical significance (P=0.079) . However, the detection rate of 18 patients who had no antibiotics before operation was 16/18 (88.89%) in the DTT group, 10/18 (55.56%) in the direct group, and 9/18 (50.00%) in the saline group, which was statistically signifi- cant (P<0.05) . Pairwise comparison showed that the detection rate of DTT group was significantly higher than that of saline group (P= 0.014) , but not significantly different between DTT group and direct group. [Conclusion] Soaking pathological tissues with DTT does im- prove the detection rate of pathogenic microorganisms in PJI.

Abstract:[Objective] To observe the histological changes in terms of bone microstructure of the lumbar spine and femur in ovariecto- mized rats. [Methods] A total of 50 12-week-age female SD rats were divided into two groups by random number table method, 25 of them underwent ovariectomy (OVX) , while the remaining 25 animals received sham operation (SO) . At 1, 4, 8, 12 and 16 weeks after operation, 5 animals in each group were sacrificed, and 4 μm sections were made from the L5 vertebral body and the femoral metaphysis with HE stain- ing. The trabecular width, the distance between the trabecular interval and cortical bone thickness were measured by usign NS-Elements D microscopic image processing software. [Results] The width of trabecular bone significantly decreased (P＜0.05) , whereas the distance be- tween trabecular bone significantly increased (P＜0.05) , and the cortical bone thickness remained unchanged in the OVX group over time (P＞ 0.05) . By contrast, the trabecular width, the distance between trabecular and cortical bone thickness remained unchanged in the SO group (P＞0.05) . In term of comparison between two groups, there were no significant differences in the width of bone trabecular and the distance between the two groups at 1-8 weeks after surgery (P＞0.05) , while the OVX group had significantly lower width of trabecular bone, greater distance between trabecular bone than the SO group at 12 and 16 weeks after surgery (P＜0.05) . However, there was no significant difference in cortical bone thickness between the two groups (P＞0.05) . [Conclusion] After ovariectomy, the rat has significantly osteoporotic bone mi- crostructure variations, which in lumbar vertebrae is earlier than that in the femur, and in the trabecular bone earlier than that in cortical bone. The bone morphometry has certain diagnostic significance.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of medial opening wedge high tibial osteoto- my (MOWHTO) under OrthoPilot navigation for medial knee osteoarthritis. [Methods] From August 2018 to February 2021, 34 patients (44 knees) with osteoarthritis in the medial compartment of the knee were treated with the above surgical methods. The surgical plan was made by using the "osteotomy master" preoperatively. Intraoperatively, the OrthoPilot navigation was used to register the medial and lateral femo- ral condyles, the medial tibia platform midpoint, knee center at 90 degrees of flexion, medial and lateral ankle high points, as well as hip, knee and ankle centers to get knee varus angle and mechanical aligment by the relative position of the tibia platform. Osteotomy was per- formed according to the plan, then a spreader was used to hold the osteotomy gap until the navigation displayed the alignment adjusted to Fugisawa point. Finally, a Tomofix plate was used to fix the osteotomy. [Results] Of the 34 patients, 4 knees (4/44, 9.09%) had hinge frac- ture during operation, and 1 case had wound infection after operation. The follow-up lasted for (22.32±7.88) months. The HSS score signifi- cantly improved at last follow-up significantly compared with that before surgery (P＜0.05) , with satisfaction rate of 94.12% (32/34) at lat- est follow-up. [Conclusion] This OrthoPilot navigation assisted MOWHTO is an effective surgical method for medial knee osteoarthritis, which does significantly improve the symptoms with high postoperative satisfaction.

Abstract:[Objective] To explore the efficacy of intravenous and intrathecal antibiotics for intracranial infection secondary to spinal surgery. [Methods] A total of 9 patients with intracranial infection after spinal surgery were treated with intravenous and intrathecal antibi- otics. The clinical and laboratory results were observed. [Results] There were no serious complications such as cerebral hemorrhage, cere- bral hernia and nerve injury during the treatment. All the patients had temperature returned to normal in (2.22±1.39) days after treatment with intravenous administration for (21.89±8.99) days, and intrathecal injection of (10.67±8.12) times. All patients were cured and dis- charged with hospital stay of (40.67±12.79) days. No symptoms recurred in anyone of them during follow-up period. In terms of laboratory tests, the blood WBC count, neutrocyte ratio, CPR, ESR and WBC count of CSF significantly decreased over time (P＜0.05) . [Conclusion] The intravenous and intrathecal antibiotics do achieve satisfactory clinical results for intracranial infection secondary to spinal surgery.

Abstract:[Objective] To evaluate the clinical results of oblique lateral lumbar interbody fusion (OLIF) combined with percutaneous pedicle screw fixation for lumbar spondylolisthesis. [Methods] From October 2018 to February 2020, 36 patients underwent abovemen- tioned surgical operation for grade I and II lumbar spondylolisthesis in our hospital. The clinical and imaging consequences were summa- rized. [Results] All the patients were successfully operated on without serious complications, while with operative time of (112.24±13.51) min and intraoperative blood loss of (103.62±11.87) ml, and well incision healing. The VAS scores for low back pain and leg pain, as well as ODI score significantly decreased at the latest follow-up compared with those preoperatively (P＜0.05) . In terms of imaging, the extent of ver- tebral slippage decreased significantly (P＜0.05) , while the heights of intervertebral space and foramen increased significantly (P＜0.05) , with fusion rate of 100% at the latest follow up. [Conclusion] The OLIF combined with percutaneous pedicle screw fixation does effectively reduce spondylolisthesis, decompress indirectly, and achieve satisfactory clinical outcomes in the early stage.

Abstract:[Objective] To investigate the clinical efficacy of membrane induction technique in the treatment of Cierny-Mader type IV chronic osteomyelitis of the femur. [Methods] From January 2016 to December 2019, 42 patients with Cierny-Mader type IV osteomyelitis of the femur were treated with two stages of surgery. In the first stage a thorough debridement followed by antibiotic bone cement filling com- bined with internal fixation were conducted, while in the second stage bone grafting and internal fixation adjustment were performed second- ary to bone cement removal. The documents regarding to clinical setting and imaging were observed. [Results] The length of bone defect ranged from 5 to 16 cm with an average of (8.24±1.16) cm after the thorough debridement in the first stage with well wound closure. The inter- val between the two stages of surgery was 6~16 weeks, with an average of (9.21±1.83) weeks, and the incision healed well after the second stage of surgery. As time went during the follow-up time lasted for (24.71±3.13) months, the range of motions (ROMs) of both hip and knee, as well as Harris and HSS scores significantly increased (P<0.05) , and Paley grade for bone defect healing significantly improved (P<0.05) . At the latest follow- up, all patients achieved radiographic fracture healing with healing time ranging from 6 to 16 months. [Conclusion] This membrane induction technique combined with internal fixation is an effective treatment for Cierny-Mader type IV chronic osteomyelitis of the femur with a benefit of high-efficient control of infection to achieve bone healing.

Abstract:[Objective] To exlpore the efficacy and safety of unilateral biportal endoscopy (UBE) in the treatment of lumbar disc hernia- tion. [Methods] From January 2020 to August 2020, 36 patients, including 23 males and 13 females aged (39.30±13.90) years on a mean, were treated by UBE technique for lumbar disc herniation involving L3/4 in a case, L4/5 in 18 cases and L5S1 in 17 cases. The clinical and im- aging consequences were evaluated. [Results] All patients had UBE discectomy completed successfully with operation time of (89.19±35.20) min, postoperative drainage volume of (19.25±15.90) ml, and hospital stay of (3.53±2.14) days. All the patients had no serious intraoperative complications, except one patient who got nerve root injury that not lead serious consequence. As time went during the follow up period last- ed for (4.30±1.23) months, the low back pain and leg pain VAS scores, as well as Oswestry index significantly improved (P<0.05) . According to the modified Macnab’s criteria, the excellent and good rate of clinical results was of 91.67%. Radiographically, a significant decrease of the intervertebral height, whereas a significant enlargement of spinal canal area was found at the latest follow up compared with those preop- eratively (P<0.05) . [Conclusion] The UBE technique has a character of relatively easy to be mastered, is a safe and feasible method for the treatment of lumbar disc herniation.

Abstract:[Objective] To explore the short-term clinical outcomes of decompression and unilateral non-fusion pedicle screw fixation by the Quadrant channel for lumbar disc herniation. [Methods] From January 2017 to April 2019, a total of 50 patients underwent abovemen- tioned surgical treatment for lumbar disc herniation complicated with or without unilateral lateral recess stenosis, including 42 cases with sin- gle level involved and 8 cases with double levels affected. The perioperative and follow-up results were analyzed. [Results] All patients were successfully operated on without serious complications. Although the single- segment group had significantly less operative time, incision length, intraoperative fluoroscopy times and postoperative drainage than the double-segment group (P＜0.05) , there were no significant dif- ferences in postoperative ambulation time and hospital stay between the two groups (P＞0.05) . As time went during the follow-up lasted for (21.83±6.87) months, the VAS scores for low back pain and leg pain, as well as the ODI score significantly decreased (P＜0.05) . The clinical results were graded as excellent in 41 cases, good in 6 cases and fair in 3 cases, with the excellent and good rate of 94.00% at the latest fol- low-up. [Conclusion] The decompression and unilateral non-fusion pedicle screw fixation by the Quadrant channel do achieve satisfactory short-term outcomes for lumbar disc herniation with or without unilateral recess stenosis with minimizing iatrogenic trauma, however the long-term consequence needs further observation.