Abstract:[Objective] To explore the early impact of diabetes mellitus (DM) on total knee arthroplasty (TKA) . [Methods] A retrospec- tive study was conducted on 252 patients who underwent primary TKA for knee osteoarthritis in our hospital. The patients were divided into two groups according to whether they had diabetes or not, including 138 cases in the non-DM group and 114 cases in the DM group. The ex- tents of knee swelling, pain and function were evaluated and compared between the two groups. [Results] Although there were no signifi- cant differences in operative time, incision length and postoperative drainage between the two groups (P＜0.05) , the non-DM group proved significantly superior to the DM group in terms of intraoperative blood loss, wound healing and hospital stay (P＜0.05) . All patients were fol- lowed up for 6~8 months with an average of (6.56±1.35) months. The VAS score and bilateral difference of knee circumference significantly decreased (P＜0.05) , whereas the knee ROM and HSS significantly increased in both groups over time (P＜0.05) . The non-DM group was significantly superior to the DM group in abovementioned items from 1 to 3 months postoperatively (P＜0.05) , despite of the fact that the dif- ferences between the two group in VAS, ROM and HSS score became not statistically significant at 6 months postoperatively (P＞0.05) . Ra- diographically, the femorotibial angle (FTA) and medial proximal tibial angle (MPTA) significantly improved (P＜0.05) , whereas the posteri- or tibial slope (PTS) remained unchanged postoperatively in both groups compared with those preoperatively (P＜0.05) . However, there were no statistically significant differences in FTA, MPTA and PTS between the two groups at any corresponding time points (P＞0.05) . [Conclusion] The DM does impair early postoperative functional recovery of TKA, with increasing affected knee swelling, reducing the range of mo- tion and functional score of affected knee, and increasing the risk of postoperative complications.

Abstract:[Objective] To evaluate the significance of thromboelastography used in anticoagulation during perioperative period of total hip arthroplasty in the elderly. [Methods] A total of 200 patients who were undergoing total hip arthroplasty in Changsha Central Hospital from May 2018 to December 2020 were enrolled into this study. According to random number table method, they were divided into two groups. Of them, 100 patients were routinely given low-molecular-weight heparin calcium at a fixed program 6 hours after surgery (the fixed group), whereas the remaining 100 patients received anticoagulant therapy based on the results of thromboelastography 6 hours after surgery dynamically (the dynamic group) . The occurrence of postoperative thrombosis was observed, and the results of thromboelastography were compared between the two groups. The parameters of thromboelastography were analyzed by ROC to predict the occurrence of thrombo- sis. [Results] There were no significant differences in operative time, incision length, intraoperative blood loss, postoperative drainage vol- ume, incision healing and time of thrombosis between the two groups (P＜0.05) . However, the dynamic group proved significantly superior to the fixed group in terms of total hospital stay and time to return walking postoperatively (P＜0.05) , additionally, the dynamic group had significantly lower incidence of thrombosis than the fixed group (P＜0.05) . At 24 and 48 days postoperatively, the dynamic group had signifi- cantly higher R and K values, whereas significantly lower MA, Angle-α and CI values than the fixed group (P＜0.05) . As results of ROC analysis, the K value had the highest sensitivity (80.0%) and specificity (99.5%) for predicting thrombogenesis, with AUC=0.924. [Conclusion] Thromboelastography do guide postoperative anticoagulation that effectively regulate coagulation factors and platelet function, reduce the incidence of postoperative lower extremity deep vein thrombosis, and improve surgical safety in total hip arthroplasty.

Abstract:[Objective] To investigate the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)for degenerative spondylolisthesis (DS) . [Methods] A retrospective study was conducted on a total of 101 patients who were admitted to ourhospital from April 2016 to December 2018 for single-segment DS. According to doctor-patient communication results, 53 patients under-went MIS-TLIF (MIS group) , while the other 48 patients underwent open TLIF surgery (open group) . The perioperative, follow-up and im-aging data of the two groups were compared. [Results] All patients in both groups had operation performed successfully without a signifi-cant difference in the operation time between the two groups (P＞0.05) . However, the MIS group proved significantly superior to the opengroup in terms of total incision length, intraoperative blood loss, postoperative drainage, time to resume ambulation and hospital stay (P＜0.05) . As time went during follow up period lasted for (28.32±9.65) months on average, the VAS and ODI scores decreased significantly inboth groups (P＜0.05) . There was no significant difference in VAS score between the two groups at 6 months after surgery and the latest fol-low-up (P＞0.05) , but ODI score of MIS group was significantly better than that of the open group at the latest follow-up (P＜0.05) . Radio-graphically, the intervertebral space height increased significantly (P＜0.05) , whereas the percentage of vertebral slippage significantly de-creased in both groups postoperatively compared with those preoperatively (P＜0.05) . At any corresponding time points, there was no statis-tically significant differences in the above image indexes between the two groups (P＞0.05) . [Conclusion] Minimally invasive transforami-nal lumbar fusion has benefits of minimizing iatrogenic trauma and facilitating postoperative recovery over the open counterpart for singlespace degenerative lumbar spondylolisthesis.

Abstract:[Objective] To explore the effect of obesity on posterior lumbar interbody fusion (PLIF) for degenerative lumbar spinal ste- nosis (DLSS) . [Methods] A retrospective study was conducted on a total of 124 patients who underwent PLIF for DLSS in our hospital from January 2017 to December 2019. According to the preoperative BMI, 42 patients who had BMI ≥28.0 kg/m2 were fall into the obese group, while the remained 82 patients who had BMI＜28 kg/m2 were enrolled into the non-obese group. The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] All patients had operation completed successfully. The non-obese group was significantly superior to the obese group in terms of operation time, incision length, intraoperative blood loss, postoper- ative drainage, time to resume walking, time to remove stitches and incidence of incision complications (P＜0.05) . All patients were fol- lowed up for 16~25 months, with an average of (19.58±2.71) months. The VAS score and ODI index of the two groups were significantly im- proved over time. However, there was no significant difference in VAS score and ODI index between the two groups at any corresponding time point (P＞0.05) . With respect of imaging, the disc height significantly increased at the last follow-up and 3 months after operation in both groups compared with those before operation (P＜0.05) . At the last follow-up, there was no significant difference in interbody fusion in term of BSF classification between the two groups (P＞0.05) , but the degeneration rate of adjacent vertebrae in the obese group was higher than that in the non-obese group (16.67% vs 4.88%, P＜0.05) . [Conclusion] Obesity increases the intraoperative bleeding, the incidence of incision complications and the risk of adjacent vertebral degeneration in PLIF for DLSS.

Abstract:[Objective] To compare the clincal efficacy of bilateral intermuscular approaches (BIM) versus a posterior midline approach (PML) for transforaminal lumbar interbody fusion (TLIF) . [Methods] A retrospective study was conducted on 62 patient who received TLIF for L4/5 spinal canal stenosis accompanied with segmental instability in our hospital From May 2016 to May 2018. According to the preoper- ative doctor-patient communication, 31 patients had TLIF performed through the BIM approach, while the remaining 31 patients had the operation conducted through the PML approach. The documents regarding to perioperative period, follow- up and radiographs were com- pared between the two groups. [Results] All patients in both groups were operated on successfully without serious complications. The BIM group proved significantly superior to the PML group in terms of total incision length, operation time, intraoperative blood loss and postoper- ative drainage volume (P＜0.05) , but there were no significant differences in intraoperative fluoroscopy times, incision healing grades and hospital stay between the two groups (P＞0.05) . All patients in both groups were followed up for more than 12 months, and there was no sta- tistical significance in the time to resume total weight-bearing activity between the two groups (P＞0.05) . The VAS and ODI scores signifi- cantly decreased (P＜0.05) , while JOA scores significantly increased over time in both groups (P＜0.05) . The BIM group was significantly superior to the PML group in above-mentioned scores at 3 months after surgery (P＜0.05) , whereas which all became not statistically signifi- cant at the latest follow-up between the two groups (P＞0.05) . With respect to imaging evaluation, the BIM group had significantly greater FCSA/TCSA ratio of the paraspinal muscle than the PML group at 6 months after surgery and the latest follow-up (P＜0.05) . [Conclusion] Bilateral intermuscular approaches have advantages of shortening operation time, reducing blood loss, and preserving more functional units of multifidus over the posterior midline approach for TLIF.

Abstract:[Objective] To explore the clinical outcomes of debridement, antibiotics and implant retention (DAIR) combined with irriga- tion drainage for periprosthetic joint infection (PJI) . [Methods] A retrospective study was done on 21 patients (21 knees) who were admit- ted into our hospital for acute PJI from January 2012 to June 2020. All patients were treated with DAIR combined with irrigation and drain- age. The VAS and HSS scores, as well as knee extensor-flexion range of motion (ROM) and laboratory test results were compared among dif- ferent time points, additionally the successful rate of infection control was evaluated. [Results] All patients were successfully operated on without serious complications such as vascular and nerve injury. The 21 patients were followed up for (3.62±2.50) years. Among them, 15 cases got successful infection control, accounted for 71.43% , whereas the remaining 6 patients had infection recurred, accounted for 28.57%, which controlled well after the two-stage revision. The HSS score and ROM increased significantly (P＜0.05) , whereas the VAS score decreased significantly over time postoperatively (P＜0.05) . In terms of bacteriology, 14 patients got positive results, while 7 were of negative among the 21 patients. The positive results involved 8 cases of staphylococcus aureus, including 5 cases of MRSA; 3 cases of Staphylococcus epidermidis; 1 case of pseudomonas aeruginosa and 2 cases of gram-negative bacilli. In terms of blood test, ESR, CRP and IL-6 were significantly decreased after operation compared with those preoperatively (P＜0.05) . The regular radiographic checks revealed that the prosthetic components remained in proper positions without fracture, loosening, and no obvious lightening shadow was seen. [Conclusion] The DAIR combined with irrigation drainage do effectively control infection and preserve good joint function for acute PJI.

Abstract:[Objective] To compare the clinical outcomes of anterior cervical corpectomy and fusion (ACCF) combined with anterior cervical discectomy and fusion (ACDF) versus multi- segment mere ACDF for multi- segment cervical spondylotic myelopathy (CSM) . [Methods] A retrospective study was conducted on 86 patients who underwent anterior decompression and fusion for multi-segment CSM in our hospital from August 2015 to August 2019. Of them, 21 patients received combined procedures (single- segment ACCF +ACDF), while the remaining 65 patients had multi-segment mere ACDFs performed. The perioperative, follow-up and imaging data were compared between the two groups. [Results] The combined group had significantly greater intraoperative blood loss than the ACDF group (P＜0.05) , but there was no significant difference in the operation time, the incidence of early complications, and hospital stay between the two groups (P＞0.05) . Before operation, the deep reflex scale and pathological reflex grade was much serious in the combined group than those in the ACDF group (P＜0.05) . Compared with pre-operatively, the deep reflex scale, pathological reflex grade, VAS score and NDI score improved significantly in both groups postoperatively (P＜0.05) . At corresponding time points, the deep reflex scale and pathological reflex grade be- came much better in the combined group than in the ACDF group (P＜0.05) , whereas no significant difference was noted in VAS and NDI scores between the two groups (P＞0.05) . With respect to imaging assessment, no differences in CL and SVA was found between two groups (P＞0.05) , but SCA was much less in the combined group than that in the ACDF group preoperatively (P＜0.05) , which all significantly im- proved at the last follow-up (P＜0.05) , and no significant difference was found between two groups (P＞0.05) . [Conclusion] For multi-seg- ment CSM, the single-segment ACCF combined with ACDF might provide sufficient decompression which multi-segment mere ACDF can-not provide, is a safe and effective alternative to the long-segment ACCF to avoid the potential complications of long-segment ACCF.

Abstract:[Objective] To explore the impact of blood pressure levels on bone mineral density (BMD) in elderly males with type II dia- betes mellitus (T2DM) , and analyze other factors that may influence BMD in this population. [Methods] A total of 99 middle-aged and el- derly males who were hospitalized for T2DM in our hospital from April 2019 to October 2020 were enrolled into this study. Data regarding to general states and disease history were collected, blood pressure, bone mineral density and blood lipids were measured. Univariate com- parison among different groupings, Pearson correlation and multiple regression were conducted. [Results] L_1~4 bone mineral density (BMD) in the normal blood pressure group and mild hypertension group was significantly higher than that in moderate hypertension group (P＜ 0.05) , but there were no significant differences in other general data and laboratory test results among the three groups (P＞0.05) . As re- sults of Pearson correlation analysis of 99 patients, the lumbar BMD was significantly negatively correlated with systolic blood pressure (P＜ 0.05) , positively correlated with LDL-C (P＜0.05) , and negatively correlated with smoking duration (P＜0.05) . In term of stepped multiple regression, LDL-c (B=0.039, P＜0.05) , systolic blood pressure (B=-0.003, P＜0.05) , smoking duration (B=-0.002, P＜0.05) were the factors related to BMD. [Conclusion] For middle-aged and elderly males with T2DM, controlling blood pressure at a lower level is more benefi- cial to bone health.

Abstract:[Objective] To explore the correlation between pain symptoms and imaging grades in knee osteoarthritis. [Methods] A total of 285 patents who visited in out-patient department for knee osteoarthritis in our hospital were included in this study. The patients aged from 44 to 61 years, including 107 males and 178 females, with the course of disease ranging from 2 to 8 months. The correlations between pain symptoms and clinical and imaging grading parameters were analyzed. [Results] The patients with mild pain were significantly elder (P＜0.05) , of male dominated (P＜0.05) , shorter course of disease (P＜0.05) , higher HSS score, less extent of genu in terms of femorotibial angle (FTA) and medial proximal tibial angle (MPTA), higher Kellgren-Lawrence (K-L) grade in X-ray films (P＜0.05) and lower bone mar- row edema (BME) grade on MRI than those with severe pain. However, there were no statistically significant differences in the main symp- tom side and body mass index (BMI) between the two groups (P＞0.05) . As results of Spearman correlation analysis, there was a significant- ly negative correlation between VAS score and K-L grade (P＜0.05) , whereas there was a significant positive correlation between VAS score and BME grade (P＜0.05) . There was no a correlation between K-L grade and BME grade (P＞0.05) . In term of multiple linear stepwise re- gression, the HSS (β=-0.736, P＜0.001) and the age (β=-0.123, P=0.002) were negatively correlated with VAS score. [Conclusion] The BME revealed by MRI has a positive correlation with pain symptoms.

Abstract:[Objective] To compare the clinical outcomes of the high tibial osteotomy (HTO) versus unicompartmental knee arthroplas- ty (UKA) for medial compartment osteoarthritis of the knee. [Methods] The Cochrane Library, PubMed, EMBASE, CNKI, Wanfang, VIP and CBM database were searched for the clinical outcomes of HTO versus UKA for medial compartment osteoarthritis of the knee from Janu- ary 2000 to December 2020. Literature screening, quality assessment, and data extraction were conducted based on inclusion and exclusion criteria. RevMan5.3 was used to perform the meta-analysis of parameters related to the consequences. [Results] A total of 17 studies were included, involving 1 549 knee, including 688 knees in the HTO group and 861 knees in the UKA group. As results of meta-analysis, the UKA group proved significantly superior to the HTO group in terms of postoperative complications [OR=4.52, 95%CI (2.30, 8.90) , P＜ 0.0001] , Lysholm score [MD= -5.53, 95% CI (-11.11, 0.05) , P=0.05] , revision rate [OR=1.67, 95% CI (1.01, 2.76) , P=0.05] . However, there were no significant differences between the two groups in terms of operation time, blood loss, other knee functional scroes, range of mo- tion, excellent and good rates of clinical consequences, as well as mechanical axis of the lower limb and cartilage degeneration measured on radiographs (P＞0.05) . [Conclusion] Both HTO and UKA achieve similarly satisfactory clinical outcomes for medial compartment osteoar- thritis of the knee, whereas the UKA has advantages in terms of postoperative complications, Lysholm score and revision rate over the HTO.

Abstract:Flat foot is a common foot deformity in children, while which is a normal physiological state in infancy. As children grow old- er, some children will gradually form foot arches, whereas some children will have this deformity continuously into adulthood with symp- toms. The flat foot can be divided into flexible flat foot and rigid flat foot based on the presence or absence of normal arch height under load- ing conditions. As parents pay more attention to this disorder in recent years, more and more children will be diagnosed of flexible flat feet at early stage and receive intervention. Orthotic insole is the first choice for such patients. In this paper, the current status and shortcomings of the research on the use of orthotic insoles for flexible flat foot in children will be summarized, additionally, the future development of this field will be prospected.

Abstract:Cerebral palsy is the most common disabling disease in children, while surgery and rehabilitation training are the main treat- ment methods for it. This paper summarizes the current status and relationship between surgery and rehabilitation training for cerebral pal- sy, analyzes the necessity, problems and corresponding strategies of constructing an integrated mode of surgery and rehabilitation therapy for cerebral palsy, in order to promote multidisciplinary collaboration in the diagnosis and treatment of cerebral palsy.

Abstract:Osteosarcoma，a kind of malignant bone tumor that often occurs in adolescents，has a strong metastatic capacity and poor prognosis. The occurrence of osteosarcoma and its resistance to cisplatin is known to be related to ERCC gene. As a key component of the nucleotide excision repair pathway, ERCC gene is found to regulate DNA repair. ERCC functional differences are mainly related to single nucleotide polymorphisms. The low expression may increase the risk of osteosarcoma, whereas the high expression may increase the resis- tance to cisplatin. In addition, ERCC gene is related to occurrence and prognosis of osteosarcoma, and is of great significance to the chemo- therapy drugs selection. The targeted inhibition of ERCC provides possibility to reduce the resistance of cisplatin. Our review highlights the research progress of ERCC in osteosarcoma and provides relevant concepts for further clinical translational applications.

Abstract:[Objective] To analyze the core genes and functional pathways in the differential expression profile of osteosarcoma based on bioinformatics analysis. [Methods] In this study, two microarray datasets, including GSE11414 and GSE14359, from the gene expres- sion omnibus (GEO) database were used to screen differentially expressed genes (DEGs) between human osteosarcoma and osteoblasts sam- ples. The potential biological functions of DEGs were explored through the Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment analyses. The Search Tool for the Retrieval of Interacting Genes (STRING) database and Cy- toscape software were used to further construct a protein-protein interaction network and screen core genes. Finally, the prognostic value of core genes in osteosarcoma was assessed using the Long-term Outcome and Gene Expression Profiling database of pan-cancers (LOGpc) database. [Results] There were 111 DEGs in GSE11414 and GSE14359, including 28 up-regulated and 83 down-regulated DEGs. Func- tional enrichment analysis showed that DEGs were mainly enriched in the extracellular matrix organization, integrin binding, glycosamino- glycan binding, collagen-containing extracellular matrix, p53 signaling pathway, and TGF-β signaling pathway. Ten core genes were ob- tained by protein-protein interaction network analysis. Recurrence-free survival analysis confirmed that high expression of THBS1 and IGFBP3 was associated with poor prognosis in patients with osteosarcoma. [Conclusion] In this study, the protein-protein interaction net- work of differential genes in osteosarcoma was constructed by bioinformatics analysis. The core genes closely related to the pathogenesis of osteosarcoma were explored, which may provide new prognostic markers and therapeutic targets for osteosarcoma.

Abstract:[Objective] To introduce the surgical technique and its preliminary outcomes of closed reduction and percutaneous cannu- lated screw fixation under temporary distraction by external frames for Sanders type II and III calcaneal fractures. [Methods] From October 2019 to December 2020, 16 patients received closed reduction and percutaneous cannulated screw fixation for Sanders type II and III calca- neal fractures. After the patients were placed in the healthy lateral decubitus position, a Schanze pin was inserted transversely through the calcaneus tuberosity and the talus respectively. A pair of external frames was attached with the pins on the medial and lateral sides. Distrac- tion was applied by the frames to correct varus and shorten deformities, and restore smooth articular surface and calcaneal shape. Finally, percutaneous cannulated screws were placed to fix the calcaneal fractures. [Results] All patients had surgical procedures performed suc- cessfully with no serious complications, such as vascular and nerve injury, whereas with operation time of (98.00±14.76) min. All patients got incision healing well without non- healing, delayed healing, or superficial and deep tissue infection. All patients had Gissane angle, Bohler angle, calcaneus length, calcaneus width and height recovered well on radiographs postoperatively, with the excellent and good rate of 93.75%. [Conclusion] The closed reduction and percutaneous cannulated screw fixation under bilateral distraction for calcaneal frac- tures has benefits of fewer postoperative incision complications, shortening preoperative waiting time, and achieve sound preliminary clini- cal outcomes.

Abstract:[Objective] To introduce the techniques and preliminary clinical outcomes of three-dimensional preoperative planning in total hip arthroplasty (THA) . [Methods] From May 2019 to June 2020, 8 patients received THA with assistance of three-dimensional pre- operative planning. Three-dimensional CT thin-layer scanning of the hip joints was performed before the operation to establish a three-di- mensional model. Anatomical landmarks were determined on the three-dimensional images, the original anatomical shape and pathological changes were analyzed, and simulated surgical operations and prosthesis implantation were conducted. After that, the real THA was fin- ished according to preoperative planning. [Results] As results of postoperative radiographic measurements, acetabular component was placed with abduction angle of (41.63±4.63)° and anteversion angle of (19.13±5.57)° ; whereas the femoral component was inserted with an- teversion angle of (14.38±6.35)° and limb length change of (-0.40±1.06) mm. Of the 8 patients, 6 patients had same size acetabular prosthe- sis used as three-dimensional preoperative planning, 1 patient had 1 grade difference and another had 2 grade difference. In addition, 3 pa- tients had same size femoral component implanted as three-dimensional preoperative planning, 3 patients had 1 grade difference and other 2 had 2 grade difference. [Conclusion] This three-dimensional preoperative planning does accurately estimate the prosthetic size and posi- tion placed.

Abstract:

[Objective] To explore the efficacy of MRI functional imaging used for evaluation of early ankylosing spondylitis (AS) sacro- iliac arthritis. [Methods] A total of 48 patients who received comprehensive treatment with Chinese and Western medicine for AS were re- viewed. The clinical score, laboratory tests and MRI parameters were collected and compared, including BASDAI score, CRP, ESR, STIR, and parameters of MRI IVIM, additionally, correlations among the clinical score, laboratory tests and imaging data were searched. [Results] Compared with those before treatment, the BASDAI score, ESR, CRP, SPARCC score, ADC_slow and f value significantly decreased after treatment (P<0.05) , whereas the ADC_fast remained unchanged (P>0.05) . In term of relationship, the SPARCC score and ADC_slow were high- ly correlated with BASDAI score and CRP (P<0.001) , moderately correlated with ESR (P<0.05) . In addition, there was a moderate and low correlation of f value with BASDAI score, CRP and ESR (P<0.05) , however, there was no clear correlation of ADC_fast with BASDAI score, ESR and CRP. [Conclusion] MRI functional imaging items, such as SPARCC score, ADC_slow and f value might be effective in evaluating the therapeutic outcomes of AS sacroiliac arthritis.

Abstract:[Objective] To compare the clinical results of direct anterior approach (DAA) versus anterolateral approach (ALA) for total hip arthroplasty (THA) . [Methods] A total of 95 patients underwent total hip arthroplasty in our hospital from January 2018 to April 2020. Among them, 43 patients had THA performed through DAA, while the remaining 52 patients were through ALA. The early clinical out- comes were compared between the two groups. [Results] The operation was successfully completed in both groups. The DAA group was sig- nificantly superior to the ALA group in terms of operative time, intraoperative blood loss, incision length, 1 min walking distance at 1 day and 2days postoperatively, and hospital stay (P＜0.05) . The Harris scores increased significantly over time in both groups (P＜0.05) . At 1 and 3 months after surgery, the DAA group had significantly higher Harris score than the ALA group. [Conclusion] The direct anterior ap- proach for total hip arthroplasty has the advantages of minimizing iatrogenic trauma and enhancing recovery.

Abstract:[Objective] To observe the efficacy of closed irrigation-drainage with constant pressure for cerebrospinal fluid leakage in spinal infectious diseases. [Methods] A retrospective study was done on 11 patients who received intraoperative repair and postoperative closed irrigation-drainage with constant pressure for cerebrospinal fluid leakage secondary to surgical treatment for spinal infectious diseas- es in our hospital from February 2011 to January 2021. [Results] All the 11 patients were successfully operated on with wound healing well. There were no manifestations of intracranial infection, such as headache and meningeal irritation in anyone of them. Pathological biopsy in operation revealed that 4 cases were of suppurative infection, 3 cases were tuberculosis bacillus infection, and remaining 4 cases were in- flammatory tissue without definite infection. The VAS score, temperature, ESR and CRP decreased significantly over time in the early stage after operation (P＜0.05) . The postoperative MRI showed no cerebrospinal fluid exudation and no cerebrospinal fluid cyst in any case. Dur- ing the follow up period lasted for more than 12 months, no symptoms, such as high fever and severe back pain, occurred again in any case. The VAS and ODI scores decreased significantly, whereas JOA score increased significantly over time in 11 patients (P＜0.05) . [Conclusion] Intraoperative repair and postoperative closed irrigation-drainage with constant pressure are safe and feasible treatment for cerebro- spinal fluid leakage in spinal infectious diseases.