Abstract:Abnormal blood glucose is closely related to the occurrence and prognosis of perioperative complications in spinal surgery. Perioperative blood glucose control is an important aspect of clinical management in patients who underwent spinal surgeris, and it is also one of the important contents to reduce the incidence of surgical complications and promote rapid recovery after surgery. At present, there is a lack of expert consensus and guidelines for perioperative blood glucose management in spinal surgery in China. In order to further standard- ize perioperative blood glucose management in spinal surgery, we reviewed the existing guidelines and consensus on perioperative blood glu- cose management in the relative fields, systematically evaluated the published literature regarding blood glucose management, combined with the characteristics of spinal surgery, organized experts to discuss, and proposed a standardized consensus on perioperative blood glu- cose management in spinal surgery to provide a guidance for perioperative blood glucose management in spinal surgery.

Abstract:[Objective] To explore the radiographic features of cervical spondylosis complicated with severe intervertebral space steno- sis. [Methods] The C_2/3 or C_3/4 intervertebral space was referred to as the reference intervertebral space, while the space of the most severe in- tervertebral space stenosis was referred to as the target intervertebral space. Severe intervertebral space stenosis was defined if the target in- tervertebral space height was less than or equal to 50% of the reference intervertebral space height. A retrospective study was conducted on 132 patients who were diagnosed of cervical spondylosis complicated with severe intervertebral space stenosis in our department from Janu- ary 2019 to February 2022. The radiographic measurements among different segments were analyzed to explore the correlation between them. [Results] Among 132 patients, the severe intervertebral stenosis affected 1 to 4 intervertebral spaces, with a total of 225 intervertebral spaces involved. Incidence of the severe intervertebral space stenosis in different segments was ranked as 79.6% in C_5/6, 56.1% in C_6/7, 28.0% in C_4/5 and 6.8% in C_3/4. There were significant differences among all segments in terms of intervertebral space height, C_2~7 Cobb angle (cervi- cal lordotic curvature), local lordotic Cobb angle, spinous process distance in neutral position, spinous process distance in dynamic position, and the height, width and area of intervertebral foramens (P＜0.05). Regarding to correlation analysis, the spinal canal area was positively cor- related with intervertebral space height, local Cobb angle and dynamic spinous process spacing (P＜0.05), whereas not correlated to C₂~C₇ Cobb angle and neutral spinous process interval (P＞0.05). In addion, the intervertebral foramen area was positively correlated with interverte- bral space height, local lordotic Cobb angle and dynamic spinous process interval (P＜0.001), whereas not correlated to the C₂~C₇ Cobb angle and neutral spinous process interval (P＞0.05). [Conclusion] The severe intervertebral space stenosis most commonly occurres in C_5/6 inter- vertebral space, followed by C_6/7 intervertebral space. The intervertebral foramen area is significantly correlated with intervertebral space height, local lordotic Cobb angle and dynamic spinous process interval.

Abstract:[Objective] To explore the factors impacting clinical outcomes of posterior open-door cervical laminoplasty for ossification of the posterior longitudinal ligament (OPLL). [Methods] A retrospective study was done on 67 patients who underwent C₃~C₇ open-door lamino- plasty for cervical OPLL in General Hospital of Ningxia Medical University from 2015 to 2022. Univariate comparison and multiple logistic re- gression were used to analyze the related factors impacting the clinical consequences. [Results] All patients had operation completed success- fully, and were followed up for more than 24 months. According to the improvement rate of JOA score ＜60% or ≥60% at the last follow-up, 33 patients were termed as the poor group, accounting for 49.3%, while the remaining 34 patients fell into the good group, accounting for 50.7%. As results of univariate comparison, the poor group proved significantly greater than the good group in terms of age [(59.1± 9.9) years vs (52.9± 9.8) years, P=0.010], the occupying rate of cervical canal preoperatively [(50.1±15.2)% vs (41.7±12.2)%, P=0.036], T₁ slop (T₁S) [(26.8±8.7)° vs (21.5±5.8)°, P=0.013], K line negative ratio [negative /positive, (11/22) vs (4/30), P=0.034] and intramedullary high signal ratio [yes/no, (20/ 13) vs (10/24), P=0.010]. Regarding to multivariate logistic regression, the canal occupying rate (OR=83.54, P=0.006), intramedullary high signal on MRI (OR=3.13, P=0.004) and T1S (OR=1.11, P=0.036) were independent risk factors for poor clinical outcomes. The area under curve (AUC) of the predicting model analyzed by ROC was of 0.80, 95%CI 0.70~0.91, P=0.001, with the slope of the calibration curve close to 1, indicating good accuracy of the prediction model. [Conclusion] The high spinal canal occupying rate, high intramedullary signal intensity and high T₁S are independent risk factors for poor surgical outcomes of open-door cervical laminoplasty for OPLL.

Abstract:[Objective] To compare the clinical outcomes of unilateral cyst-wall puncture (CWP) versus intracystic puncture (ICP) in percutaneous vertebroplasty (PVP) for stage I and II Kümmell's disease. [Methods] A retrospective study was conducted on 56 patients who underwent PVP for stage I and II Kümmell's disease from March 2017 to February 2021. According to doctor-patient communication, 30 pa- tients received CWP-PVP, while the remaining 26 patients received ICP-PVP. The perioperative, follow-up and imaging data were com- pared between the two groups. [Results] All patients in both groups had corresponding procedure performed successfully without serious in- traoperative complications. Although there were no significant differences in the operation time, first puncture success rate, bone cement leakage rate, walking time and hospital stay between the two groups (P＞0.05), the CWP group had significantly more intraoperative fluorosco- py times [(12.4±1.6) times vs (9.2±1.7) times, P＜0.05] and significantly more bone cement injected [(4.7±0.2) ml vs (4.3±0.2) ml, P＜0.05] than the ICP group. With time of follow-up lasted for (17.4±2.4) months on an average, the VAS and ODI scores significantly decreased in both groups (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Radiographi- cally, the Cobb angle, anterior and midline vertebral heights of injured vertebra were significantly improved in both groups at 3 days postoper- atively and the last follow-up (P＜0.05). There was no significant difference in the above imaging indexes between the two groups before sur- gery (P＞0.05), however, the CWP group proved significantly superior to the ICP group in terms of anterior vertebral height [3 days postopera- tively (20.5±1.9) mm vs (19.5±1.7) mm, P＜0.05; the last follow-up (20.1±1.9) mm vs (18.0±2.0) mm, P＜0.05], the middle vertebral height [3 days postoperatively (18.0±1.4) mm vs (17.2±1.2) mm, P＜0.05; the last follow-up (17.5±1.4) mm vs (16.6±1.2) mm, P＜0.05], and the local kyphotic angle [3 days postoperatively (13.9± 4.2) ° vs (16.5±5.4) °, P＜0.05; the latest follow-up (14.4±4.6) ° vs (17.9±5.7) °, P＜0.05]. [Con- clusion] The unilateral cyst-wall-puncture percutaneous vertebroplasty does achieve considerably better consequences to recover and main- tain morphology of the affected vertebrae than the intracystic counterpart for stage I and II Kümmell's disease.

Abstract:[Objective] To investigate the clinical outcomes of total synovectomy and total knee arthroplasty (TKA) with or without radio- therapy in the treatment of knee advanced pigmented villonodular synovitis (PVNS). [Methods] A retrospective study was done on 39 pa- tients who received treatment for knee advanced PVNS from June 2007 to June 2019. According to the doctor-patient communication, 20 pa- tients received total synovectomy and TKA, followed by postoperative extra-articular radiotherapy (the RT group), while the remaining 19 pa- tients received total synovectomy and TKA only (non-RT group). The perioperative, follow-up and imaging data of the two groups were com- pared. [Results] There were no significant differences in operation time, total incision length, intraoperative blood loss, pain VAS score 5 days after surgery, walking time and hospital stay between the two groups (P＞0.05). As time went during the follow- up period lasted for (36.0±2.2) months in a mean, the VAS scores significantly reduced (P＜0.05), whereas the HSS, KSS functional scores, KSS clinical scores and knee range of motion (ROM) significantly increased in both groups (P＜0.05). The last follow-up, the RT group proved significantly supe- rior to the non-RT group in terms of VAS [(1.7±0.5) vs (2.6±0.6), P＜0.001], HSS [(93.6±2.2) vs (87.1±2.1), P＜0.001], KSS functional score [(93.3±2.0) vs (87.3±1.9), P＜0.001], KSS clinical score [(93.9±1.4) vs (87.7±1.8), P＜0.001] and knee ROM [(144.4±6.1)° vs (136.9±3.8)°, P＜ 0.001]. By the latest follow-up, the RT group was significantly better than the non-RT group in recurrence rate (0% vs 21.1%, P＜0.047). Re- garding imaging, the thickness of suprapatellar effusion and suprapatellar synovial were significantly reduced in both groups after operation (P＜0.05). At the last follow-up, the RT group proved significantly superior to the non-RT group in terms of effusion thickness of suprapatel- lar bursae [(1.4±0.5) mm vs (2.6±0.7) mm, P＜0.001] and synovial thickness of suprapatellar bursae [(0.9±0.2) mm vs (1.8±0.5) mm, P＜ 0.001]. However, there was no significant difference in the T value of bone mineral density between the two groups at any time points accord- ingly (P＞0.05). [Conclusion] For knee advanced PVNS with severe bone destruction, total synovectomy and TKA with postoperative adju- vant radiotherapy does effectively prevent recurrence, with good safety, and achieve considerably better short-term clinical outcome over the counterpart without adjuvant radiotherapy.

Abstract:[Objective] To compare the efficacy of SuperPath approach versus posterolateral approach (PLA) with a small incision for to- tal hip arthroplasty (THA) in the treatment of osteonecrosis of the femoral head (ONFH). [Methods] A total of 65 patients who were admitted to our hospital from June 2017 to June 2019 for end-stage ONFH were divided into two groups by random number method. All the patients in both groups received THA, including 35 patients with SuperPath approach, while the other 30 patients with PLA approach. The periopera- tive, follow- up and radiographic documents were compared between the two groups. [Results] The surgical procedures were successfully completed in both groups without neurovascular injury and other serious complications. Although the SuperPath group consumed significant- ly longer operation time than the PLA group (P＜0.05), the former was significantly superior to the latter in terms of total incision length, time to return walking postoperatively and hospital stay (P＜0.05). The follow-up period lasted for more than 24 months. The SuperPath group re- sumed full weight- bearing activity significantly earlier than the PLA group (P＜0.05). The VAS score significantly decreased (P＜0.05), whereas Harris score significantly increased in both groups over time (P＜0.05). The SuperPath group proved significantly superior to the PLA group in abovesaid scores at 6 months after surgery (P＜0.05), nevertheless, the differences became not statistically significant between the two groups at the latest follow-up (P＞0.05). Regarding to imaging evaluation, there were no significant changes in acetabular abduction and acetabular anteversion (P＞0.05), whereas the discrepancy in limb length significantly decreased at the latest follow-up compared with those preoperatively in both groups (P＜0.05). At corresponding time points, there was no statistical significance in the above radiographic items between the two groups (P＞0.05). [Conclusion] The SuperPath approach has an advantage of minimized iatrogenic trauma over the PLA, which is beneficial to early postoperative recovery.

Abstract:[Objective] To evaluate the clinical efficacy of anterior surgery versus posterior counterpart in the treatment of thoracic spi- nal tuberculosis. [Methods] Literature retrieval was conducted in seven databases including PubMed, Embase, Cochrane, Web of Science, CKNI, VIP and Wanfang, and relevant journals were manually searched. After reading the full paper and extracting the data met the includ- ing criteria, a meta-analysis was conducted by using Revman 5.3 software. [Results] A total of 9 literatures were enrolled into this study from 11618 retrieved literatures, all of which were retrospective cohort studies. A total of 837 patients were involved, including 318 cases in the anterior approach group and 519 cases in the posterior approach group. As results of the meta-analysis, there were no statistically significant differences between the two groups in terms of operation time, intraoperative blood loss, postoperative Cobb angle correction, bone graft fu- sion time, and neurological function improvement (P＞0.05), however, the posterior group proved significantly superior to the anterior group in terms of complications [OR=2.43, 95%CI 1.50~3.94, P＜0.05] and the correct loss in Cobb angle at the latest follow-up [MD=1.16, 95%CI 0.36~1.95, P＜0.05]. [Conclusion] Both posterior and anterior surgical operations are effective in treating thoracic tuberculosis and restor- ing nerve function. By comparison, the posterior surgery have fewer complications and are more beneficial to the maintenance of kyphotic de- formity correction.

Abstract:Osteoporosis (OP) and knee osteoarthritis (KOA) are the common diseases that harm the bone health in the middle-aged and elderly, and usually occurred concomitantly in a large number of patients. Total knee arthroplasty (TKA) in such patients become difficult with increased risks of complications, such as postoperative pain, prosthetic loosening, periprosthetic fracture, with an increased chance of revision, which seriously affect the quality of life of patients. Therefore, both doctors and patients need to be aware of the serious harm of OP and KOA comorbidity to evaluate the severity of OP in patients with KOA, and to reduce the further loss of bone mass and maintain good bone condition by early medication.

Abstract:Bone-immunoregulation osteogenesis is a hot topic in the research field of bone repair. The regulatory T cell (Treg) is the core cell mediating -immunoregulation osteogenesis, which is closely related to glucocorticoid-induced osteonecrosis of femoral head (ON- FH). After the bone injured, Treg cells homed to the injured area by CCL22/CCR4 axis pathway and were activated to syntheses for tissue re- pair by promoting factors of STAT5/FoxP3 pathway with BMSCs to regulate osteogenesis and angiogenesis to promote bone repair. The MiR155/SOCS1 regulatory circuit regulates the activation of STAT5/FoxP3 pathway, whereas the glucocorticoid inhibits MiR- 155, promotes SOCS1 expression and inhibits the activation of STAT5/FoxP3 pathway and Treg cells. Targeted homing of Treg cells and MiR-155 targeted transfection in T cells to inhibit SOCS1 expression, while activate STAT5/FoxP3 pathway and Treg cells, as well as bone immunoregulation of osteogenic microenvironment mediated by Treg cells, and regulation of BMSCs-osteoblast angiogenesis and osteonecrosis might be a new approach to study the pathogenesis and prevention of glucocorticoid-induced ONFH.

Abstract:Gout refers to a metabolic disease in which monosodium urate (MSU) crystals exceed their saturation in blood or interstitial fluid, thereby depositing in joints throughout the body, which can induce local inflammatory responses and tissue structure destruction. When MSU is deposited in the facet joint, ligament flavum, epidural space, etc., it may lead to the formation of gout in the spinal canal. This disease can occur in various segments, involving cervical, thoracic and lumbar spine, with no specific clinical symptoms in the early stage and lack of conventional imaging features, therefore is very prone to misdiagnosis and mistreatment. Since the disease was first reported in 1950, several publications have summarized the pathogenesis, clinical manifestations, diagnosis and treatment of the disease. On this basis, a literature review was conducted in order to deepen the understanding of the disease.

Abstract:Cervical ligamentum flavum calcification belongs to calcium pyrophosphate dihydrate crystal deposition disease (CPPDCDD), a kind of inflammatory joint disease, and was first discovered in Japanese with female predomination, whereas which is relatively rare- ly occurs in the spine compared with other sites. The relationship between rheumatoid arthritis and the upper cervical disorder has become the focus of research for long time in the past because many patients suffered from both rheumatoid arthritis and cervical ligamentum flavum- calcification. In this paper we reported one patient, and discusses the relationship between the CPPD cervical ligamentum flavum calcifica- tion and rheumatoid arthritis by literature review to summarize the formation mechanism of CPPD and differential diagnosis of the cervical ligamentum flavum calcification, which suggested that rheumatoid may indirectly accelerate cervical ligamentum flavum calcification by CP- PD, thus causing serious consequences.

Abstract:Magnesium has similar mechanical properties to human bones, and magnesium ion is an essential trace element in the physi- ological environment, which can be degraded and absorbed in a safe and controlled manner in the human body. Therefore, magnesium are considered as one of the candidate materials for implant with good biocompatibility and biodegradation. With the continuous development of manufacturing technology, porous magnesium alloy is expected to become the most promising alternative material for making scaffold im- plant. This review covers the research progress on the properties, preparation techniques, surface modification, alloying and biological prop- erties of magnesium scaffolds. In addition, applications, challenges and future trends of the magnesium implant are discussed.

Abstract:[Objective] To introduce the surgical technique and preliminary outcome of total knee arthroplasty (TKA) with patellar ex- clusion for knee osteoarthritis (KOA) accompanied with fixed patellar dislocation. [Methods] Four elderly patients (5 knees) underwent TKA with patellar exclusion using restrictive prosthesis for KOA with fixed patellar dislocation. The joint was opened by anteromedial incision, the patella was trimmed and shaped, denervated, and the lateral retinaculum was released. As judging that the patella could not be reduced, and the patella was left in situ. After the femoral and tibial osteotomies were conducted correctly, the prosthetic components were installed re- spectively, and the incision was sutured. [Results] All patients had TKA performed successfully without serious complications, and followed up for (4.0±0.8) years on an average. Compared with those preoperatively, the VAS score [(7.0±0.9), (1.1±0.9), P＜0.001] and HSS score [(29.9±5.5), (79.2±3.6), P＜0.001] improved significantly at the latest follow-up. All the patients had knee extensor muscle strength of grade 4, and could walk normally, whereas with knee extension sag of 10°~25° in the decubitus position. No prosthesis loosening was observed in anyone of them. [Conclusion] For the elderly knee OA with fixed patellar dislocation, TKA can be performed with patellar exclusion if the functional needs of patients are not high, which does achieve satisfactory clinical outcomes, and should be used as a choice for this scenario.

Abstract:[Objective] To compare the clinical outcomes of arthroscopic suspension fixation around coracoid versus clavicular hook plate fixation for acromioclavicular dislocation. [Methods] A retrospective study was done on 55 patients who received surgical treatment for acute closed acromioclavicular dislocation in our hospitals from January 2018 to June 2021. According to the results of doctor-patient communication, 21 patients received arthroscopic suspension fixation around the coracoid (ASFC), while the other 34 patients underwent clavicular hook plate (CHP). The clinical and imaging documents were compared between the two groups. [Results] All the patients had op- eration performed successfully in both groups. The ASFC group proved significantly superior to the CHP group in terms of intraoperative blood loss [(9.8±4.9) ml vs (35.9±11.3) ml, P＜0.05] and incision length [(4.1±0.6) cm vs (7.2±1.3) cm, P＜0.05], although the former con- sumed significantly longer operation time than the latter [(89.1±18.7) min vs (61.7±12.5) min, P＜0.05]. The VAS score for pain decreased significantly (P＜0.05), while the ASES and Constant-Murley scores increased significantly over time in both groups (P＜0.05). The ASFC group was significantly better than the CHP group in terms of VAS score [(1.1±0.7) vs (1.8±0.9), P＜0.05], ASES score [(91.2±3.1) vs (80.1± 4.8), P＜0.05] and Constant-Murley score [(90.7±5.5) vs (80.2±7.4), P＜0.05] 6 months postoperatively. Radiographically, the acromioclavic- ular distance (ACD) and coracoclavicular distance (CCD) significantly decreased 6 months after surgery compared with those preoperatively in both groups (P＜0.05), which proved not statistically significant between the two groups at any time points accordingly (P＞0.05). [Conclu- sion] Compared with clavicular hook plate, the arthroscopic suspension fixation around coracoid for acromioclavicular dislocation reduces postoperative shoulder pain, and is more beneficial to the functional recovery of the shoulder.

Abstract:[Objective] To evaluate the clinical indications and outcomes of microwave ablation and curettage for giant cell tumor in the distal radius. [Methods] A retrospective study was conducted on 8 patients who received microwave ablation and curettage for giant cell tu- mor in the distal radius in our hospital, including 2 males and 6 females, with an average age of (38.0±17.6) years, tumor diameter of (4.2± 0.8) cm, 3 cases of Campanacci grade II and 5 cases of grade III. [Results] All patients had operation performed successfully without serious complications such as nerve and blood vessel injury. With time of follow- up lasted for (64.4±27.7) months, the VAS score for pain and DASH score significantly decreased (P＜0.05), while MSTS scores, wrist extension-flexion, radio-ulnar deviation and pronation-supination range of motion (ROM), as well as wrist grip strength significantly increased (P＜0.05). Radiographically, all the 8 patients had the lesion re- moved completely without pathological fracture postoperatively, and no local recurrence or lung metastasis by the latest follow-up. [Conclu- sion] Microwave ablation and curettage is safe and achieves satisfactory preliminary results for Campanacci grade II~III giant cell tumor of the distal radius.

Abstract:[Objective] To investigate the clinical efficacy of local injection of autologous plasma and bone marrow concentrate for non- union after internal fixation of tibiofibular fractures. [Methods] From January 2018 to May 2022, a total of 58 patients received local injec- tion of autologous plasma and bone marrow concentrate for nonunion secondary to internal fixation of tibiofibular fractures. The clinical and imaging data were evaluated. [Results] All the 58 patients underwent local injection therapies smoothly without serious adverse reactions, and were followed up for 2 to 8 months. Up to the last follow-up, 56 patients reached the clinical standard of fracture healing, with healing rate of 96.6%, while the remaining 2 patients received open surgeries, including bone grafting for the non-union. From the time point before treatment to 2 months, 4 months, 6 months and 8 months after treatment, the local tenderness VAS scores [(5.1±0.5), (3.8±0.3), (2.9±0.3), (2.5±0.2), (2.0±0.1), P＜0.001], weight-load shearing of the affected limb [(52.0±4.8)%, (59.4±3.5)%, (70.5±3.9)%, (81.4±2.7)%, (93.8± 2.1)%, P＜0.001] and imaging bone callus score [(1.2±0.4), (2.2±0.5), (3.5±0.4), (5.1±0.3), (6.7±0.2), P＜0.001] significantly improved. [Conclusion] Local injection of autologous plasma and bone marrow concentrate is a minimal invasive therapy technique for the nonunion secondary to internal fixation of tibiofibular fractures, with good clinical consequences.

Abstract:[Objective] To investigate the clinical outcomes of spring ligament reefing with talonavicular fixation for correction of adult flatfoot. [Methods] A retrospective study was done on 30 patients who received spring ligament reefing with talonavicular fixation, combined with other traditional procedures if necessary for stage III flatfoot in our hospital from January 2018 to June 2021. Clinical and imaging conse- quences were evaluated. [Results] All the patients were operated on successfully without neurovascular injury and other complications, and followed up for (16.7±4.8) months on an average. Compared with those preoperatively, AOFAS score significantly increased at 12 months postoperatively and the latest follow-up [(64.6±3.8), (88.9±2.8), (89.3±2.6), P＜0.001], while the VAS score for pain significantly reduced [(3.0±0.5), (0.2±0.4), (0.2±0.4), P＜0.001]. Radiographically, the Meary angle on full weight-bearing X ray [(18.2±3.4)°, (5.2±2.0)°, (5.3± 2.0)°, P＜0.001] and TCA angle [(23.3±3.0)°, (6.9±1.8)°, (6.8±1.9)°, P＜0.001] significantly reduced, while the pitch angle [(15.1±2.9)°, (22.9 ± 3.3)° , (22.7 ± 3.3)° , P＜0.001] significantly increased. [Conclusion] The spring ligament reefing with talonavicular fixation does achieve satisfactory clinical outcomes with high comfort postoperative gait for stage III adult flatfoot.

Abstract:[Objective] To investigate the relationship between age, sex, body mass index (BMI) and osteoporosis (OP) in middle-aged and elderly people. [Methods] A total of 958 local residents in Lanzhou city were included in this study. The data regarding to the physical condition of the subjects were obtained, bone mineral density (BMD) was detected, based on which whether or not OP was determined accord- ing to diagnostic criteria. Descriptive analysis was performed on the data of this population, and multi-factor logistic regression analysis was performed to explore the related factors of OP occurrence with binary variable of OP or not as the dependent variable and other factors as the independent variables. [Results] There were 457 males and 501 females in this population, aged from 40 to 89 years old with a mean (61.7± 7.5) years old. OP was detected from 2.7% to 21.5% in the male, while from 11.9% to 61.0% in the female. The BMI of both men and women decreased with age, but the differences were not statistically significant (P＞0.05). The OP detection rates increased significantly with age in both males and females (P＞0.001). The males had greater BMI than the female in the all age groups, but the differences were not statistically significant (P＞0.05). However, the detection rate of OP in males was significantly lower than that in females in all age groups (P＜0.001). As results of logistic regression, the females (OR=3.782, 95%CI 2.415~5.85, P＜0.001) and advanced age (OR=2.031, 95%CI 1.724~2.831, P＜ 0.001) were independent risk factor for OP, while greater BMI (OR=0.447, 95%CI 0.361~0.693, P＜0.001) was a protective factor for the oc- currence of OP. [Conclusion] The incidence of OP in this population increases remarkably with age, and is significantly higher in females than in males. In addition, greater BMI is a protective factor for the occurrence of OP in this population.

Abstract:[Objective] To investigate the clinical outcomes of percutaneous endoscopic along-pedicular decompression for cervical fo- raminal stenosis. [Methods] A retrospective study was conducted on 47 patients who received percutaneous endoscopic along-pedicular de- compression for cervical foraminal stenosis from June 2021 to June 2022. The clinical and imaging results were evaluated. [Results] All the 47 patients were successfully operated on, with the average operation time of (58.8±21.2) min, the average intraoperative blood loss of (17.5±8.2) ml, and the good incision healing. As time went during the follow-up period lasted for (8.2±4.5) months on an average, at the time points preoperatively, next day after operation and the latest follow- up, the visual analogue scale (VAS) of neck and shoulder pain [(5.1±1.4), (0.8±1.2), (0.4±0.7), P＜0.05], VAS score for upper limb pain [(5.1±1.4), (0.5±0.8), (0.2±0.6), P＜0.05], neck disability index (NDI) [(24.9±4.8), (2.4±2.6), (1.2±1.2), P＜0.05] significantly decreased. In terms of imaging, compared with those before surgery, the longi- tudinal foraminal diameter (IFD) [(3.5±1.1) mm, (4.6±1.1) mm, (4.3±2.2) mm, P＜0.05], the middle foraminal diameter r (MFD) [(3.4±1.2) mm, (4.5±1.3) mm, (4.4±2.5) mm, P＜0.05] significantly increased, while the distal foraminal diameter (DFD) and foraminal height (FH) re- mained unchanged the next day after operation and the latest follow-up (P＞0.05). [Conclusion] Endoscopic along-pedicle decompression for cervical foraminal stenosis is safe and reliable, with satisfactory clinical efficacy, and sufficient decompression of the internal and mid- dle foraminal outlets.