Abstract:[Objective] To compare the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) versus minimally invasive transforaminal lumbar interbody fusion (MISTLIF) for lumbar lateral recess stenosis. [Methods] A retrospective study was conducted on 62 patients who received surgical treatment for lumbar lateral recessional stenosis. According to the preoperative doctor-patient communication, 27 patients had spinal canal decompressed with PELD (the decompression group), while other 35 patients were treated with MISTLIF (the fusion group). The documents regarding to perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had operation performed successfully without serious surgical complications. The decompression group proved significantly superior to the fusion group in terms of operation time [(54.4±11.4) min vs (104.4±10.5) min, P＜0.001], total incision length [(0.9±0.1) cm vs (6.2±1.5) cm, P＜0.001], intraoperative blood loss [(38.5±18.8) ml vs (85.1±50.8) ml, P＜0.001], postoperative walking time [(10.7±6.6) days vs (29.1±12.7) days, P＜0.001] and hospital stay [(6.1±1.6) days vs (8.5±2.6) days, P＜0.001]. All patients in both groups were followed up for more than 12 months, and the decompression group resumed full weight-bearing activity significantly earlier than the fusion group [(44.6±12.6) days vs (57.7±10.0) days, P＜0.001]. The VAS scores for lower back pain and leg pain, as well as ODI score significantly declined over time in both groups (P＜0.05), whereas which were not statistically significant between the two groups at any corresponding time points (P＞0.05). Radiographically, the vertebral canal area and lateral recess diameter significantly increased in both groups at the last follow-up compared with those preoperatively (P＜0.05), while the lumbar lordosis angle remained unchanged (P＞0.05). Although there was no significant difference between the two groups before operation (P>0.05), the decompression group got significantly less spinal canal area [(165.0±7.3) mm² vs (201.5±12.9) mm² , P<0.001] and the lateral recess diameter [(4.1±0.4) mm vs (4.9±0.5) mm, P<0.001] than the fusion group at the last followup, but there was no statistically significant difference in lumbar lordosis angle between the two groups (P> 0.05). [Conclusion] The clinical consequence of the two minimally invasive procedures are comparable. However, the simple decompression with PELD technique takes advantages of more minimally invasive and faster recovery in the treatment of lumbar lateral recess stenosis over the MISTLIF.

Abstract:[Objective] To compare clinical efficacy of biportal endoscopic lumbar interbody fusion (BE-LIF) versus conventional hemilamiectomy lumbar interbody fusion (HL-LIF) for degenerative lumbar diseases. [Methods] A retrospective study was done on 78 patients who received surgical treatment for lumbar degenerative diseases in our hospital from March 2022 to November 2022. According to the results of doctor-patient discussion, 35 patients received BE-LIF, while other 41 patients underwent HL-LIF. The perioperative period, follow-up and auxiliary examination were compared between the two groups. [Results] Although the BE-LIF cohort consumed significantly longer operative time than the HL-LIF cohort, the former proved significantly superior to the latter in terms of incision length [(7.1±1.0) cm vs (11.5±2.2) cm, P＜0.001], intraoperative blood loss [(240.0±121.2) ml vs (344.9±140.9) ml, P＜0.001], postoperative walking time [(3.2±0.5) days vs (4.4±0.5) days, P＜0.001]. With time of the follow-up lasted for (15.8±2.3) months in a mean, the VAS, ODI and JOA scores in both groups significantly improved (P＜0.05). The BE-LIF group was significantly better than the HL-LIF group in terms of low back pain VAS [(1.4±0.5) vs (1.8± 0.7), P=0.005], ODI [(15.3±2.5) vs (16.7±3.2), P=0.039] and JOA score [(25.3±1.0) vs (24.2±1.5), P＜0.001] 5 months after surgery. As for imaging, the intervertebral space height and the lumbar lordosis were significantly increased in both groups after surgery (P＜0.05). However, there were no significant differences in intervertebral space height, lumbar lordosis and intervertebral fusion Bridwell grade between the two groups at any time points accordingly (P＞0.05). [Conclusion] Both of the lumbar fusion methods achieved good clinical outcomes. By comparison, the BE-LIF takes advantage of minimally invasive surgery, with less pain in early stage after operation and faster function recovery over the HL-LIF.

Abstract:[Objective] To evaluate the significance of Mimics software calculated bone cement distribution rate (DR) for evaluation of percutaneous vertebroplasty (PVP). [Methods] A retrospective study was conducted on the patients who received PVP in our hospital from March 2021 to December 2022. According to the bone cement DR measured on the Mimics software, 40 patients with high distribution rate (HDR) (DR≥20%), 40 with medium diffusion rate (MDR) (10%[Results] The HDR cohort proved significantly greater than the MDR and LDR cohorts in terms of bone cement injection volume [(7.5±1.1) ml vs (6.6±1.3) ml vs (6.4±1.2) ml, P<0.001], and the bone cement diffusion [(22.4±1.5)% vs (14.8±2.4)% vs (8.2±1.0)%, P<0.001]. However, the HDR cohort was significantly less than the MDR and LDR cohorts in the secondary fracture occurrence [case (%), 2 (5.0) vs 5 (12.5) vs 10 (25.0), P<0.001]. The VAS and ODI scores significantly decreased with time in all three groups (P<0.05), and the VAS score in the HDR group was significantly lower than those in the MDR group and LDR group at 1 year after surgery [(1.7±0.7) vs (2.2±0.8) vs (2.3±0.5), P<0.001]. As for imaging, the vertebral anterior margin height, vertebral anterior margin height ratio, and local kyphotic angle significantly improved in all three groups postoperatively compared with those preoperatively (P<0.05). At 1 year after surgery, the vertebral anterior margin he、‘ight in HDR and MDR groups was significantly highe r thanthat in LDR group [(23.1±2.1) mm vs (22.2±3.1) mm vs (21.6±1.5) mm, P<0.001], while the vertebral anterior margin height ratio in th e HDRand MDR groups was significantly higher than that in the LDR group [(82.6±7.9)% vs (80.7±4.9)% vs (77.0±5.0)%, P<0.001]. As re sults ofpaired correlation analysis, the DR was a significant negative correlated with VAS score (r=-0.333, P<0.001), while positively correlated with the height of the anterior vertebral margin (r=0.345, P<0.001) and vertebral anterior margin height (r=0.285, P=0.002). [Conclusion] In this study, the higher the distribution rate calculated by Mimics software, the better the clinical and imaging results of patients, and the lower the postoperative secondary fracture rate.

Abstract:[Objective] To investigate the short-term efficacy of three-dimensional balanced chiropractic manipulation in the treatment of ankylosing spondylitis (AS). [Methods] A total of 102 patients visited our hospital from January 2021 to June 2023 for AS were selected, and divided into two cohorts with 51 cases in each cohor by random number table method. Of them, the patients who received routine western medicine combined with three-dimensional balanced chiropractic manipulation were termed as CM group, while those who received routine western medicine only were named as RT group. The clinical, laboratory test and imaging data of the two groups were compared. [Results] Compared with those before treatment, VAS for pain, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), finger-ground distance and occipit-wall distance significantly decreased (P＜0.05), while thoracic cage motion and Schober test significantly increased in both groups 3 months after treatment (P＜0.05). The CM cohort proved significantly superior to the RT cohort in terms of pain VAS [(2.6±0.8) vs (3.8±1.0), P＜0.001], BASDAI [(1.7±0.5) vs (2.8±0.6), P＜0.001], BASFI [(14.8±5.5) vs (35.4± 8.6), P＜0.001] and finger-ground distance [(15.4±5.0) cm vs (19.3±6.2) cm, P＜0.001], occipit-wall distance [(1.7±0.5) cm vs (2.5±0.6) cm, P＜0.001], thoracic cage mobility [(3.6±0.9) cm vs (2.9±0.7) cm, P＜0.001] and Schober test [(4.9±1.0) cm vs (3.4±0.8) cm, P＜0.001] 3 months after treatment. In addition, the CM group also was significantly better than the RT group in terms of ESR, CRP, IL-6, IL-17 and IL-23 assayed in blood tests 3 months after treatment (P＜0.05). Furthermore, the CM was significantly better than the RT group regarding sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) measured on images months after treatment (P<0.05). [Conclusion] The three-dimensional balanced chiropractic manipulation is safe and effective in the treatment of AS, which can significantly relieve pain, improve spinal function and blood test and imaging parameters.

Abstract:[Objective] To compare the clinical results of primary total hip arthroplasty through direct anterior approach with or without repair of anterior capsule. [Methods] From January 2022 to July 2022, a total of 205 patients who underwent primary THA by DAA approach in our department were included in this study. According to doctor-patient communication, 102 patients had the anterior capsule resected completely, while other 103 patients had the capsule repaired after prosthetic placement. The documents regarding to perioperative period, follow-up and images were compared between the two groups. [Results] There were no significant differences in operation time, incision length, intraoperative blood loss, postoperative walking time, incision healing grade and hospital stay between the two groups (P＞0.05). All patients were followed up for more than 1 year, and there was no statistically significant difference in the time to regain full weight bearing between the two groups (P＞0.05). Compared with those preoperatively, the patients in both resection group and the repair group got significant improvements in terms of VAS score [(6.8±1.1), (0.05±0.2), P＜0.001; (6.6±1.1), (0.04±0.2), P＜0.001], Harris score [(42.7±5.9), (94.7± 1.9), P＜0.001; (41.7±6.1), (94.9±1.6), P＜0.001], hip flexion-extension ROM [(48.1±16.6)°, (122.0±5.4)°, P＜0.001; (47.1±14.7)°, (121.9± 4.6)°, P＜0.001], internal-external rotation ROM [(35.7±14.1)°, (81.4±4.2)°, P＜0.001; (32.7±13.9)°, (81.1±5.2)°, P＜0.001]. However, there was no significant difference in the above indexes between the two groups at any corresponding time points (P＞0.05). Radiographically, there were no significant differences in acetabular abduction angle, acetabular anteversion angle, bilateral femoral length difference and femoral prosthetic position between the two groups (P＞0.05). [Conclusion] In primary THA through DAA, anterior capsule resection or repair by suture has no remarkable impact on the clinical outcome. For beginners, extensive removal of the capsule is more conducive to expose the acetabulum and smooth surgical operation.

Abstract:[Objective] To investigate the relationship between the ultrasonic morphology of the medial stable structures of knee osteoarthritis (KOA) and the clinical presentations of the knee. [Methods] A total of 202 patients with unilateral knee KOA hospitalized in our hospital from March 2023 to March 2024 were included in this study. The ultrasound measurements and clinical data of the patients were collected. The correlation between ultrasonic measurements and the clinical presentations of KOA was analyzed. [Results] According to the self-reported knee instability score, the patients were divided into two groups. Of them, 140 patients were fall into the unstable group, accounting for 69.3%; while other 62 patients (30.7%) were in the stable group. The unstable group proved significantly greater than the stable group regarding to WOMAC [(45.2±4.8) vs (29.8±3.8), P＜0.001], VAS [(6.3±1.7) vs (4.4±1.5), P＜0.001], JLCA [(5.4±1.3)° vs (2.9±1.1)°, P＜ 0.001], the thickness of the medial collateral ligament [(3.5±1.4) mm vs (2.9±1.3) mm, P＜0.001], extrusion of medial meniscus [(3.8±1.4) mm vs (2.2±0.9) mm, P＜0.001], whereas the former was significantly less than the latter in terms of HSS score [(65.3±5.1) vs (88.6±3.2), P＜ 0.001], knee flexion-extension ROM [(118.4±5.3)° vs (130.5±5.13)°, P＜0.001], HKA angle [(170.9±3.7)° vs (176.2±3.1)°, P＜0.001], the muscle thickness [(1.8±0.6) cm vs (2.4±0.5) cm, P＜0.001] and the cross-sectional area of the medial vastus muscle [(9.1±2.2) cm² vs (11.3± 2.4) cm² , P＜0.001]. There was no significant difference in K-L rating between the two groups (P＞0.05). Paired correlation analysis showed that the thickness and cross-sectional area of the vastus medialis muscle were significantly positively correlated with self-reported knee instability score, HSS score, HKA angle and knee flexion-extension ROM (P＜0.05), while significantly negatively correlated with WOMAC,VAS and JLCA angle (P＜0.05). On the contrary, medial collateral ligament thickness and medial meniscus extusion were significantly negatively correlated with self-reported knee instability score, HSS score, HKA angle and knee ROM score (P＜0.05), but were significantly positively correlated with WOMAC, VAS and JLCA angle (P＜0.05). There was no correlation between the above ultrasound indicators and K-L rating. As results of multiple linear stepwise regression, the cross-sectional area of vastus medialis muscle (B=-0.101, P＜0.05), thickness of medial collateral ligament (B=0.112, P＜0.05) and medial meniscus extrusion (B=0.132, P＜0.05) were the factors affecting knee joint function. [Conclusion] For patients with self-reported knee instability, ultrasound detection of medial knee structure has clinical guiding significance.

Abstract:Spinal tuberculosis is the most common form of extra-pulmonary tuberculosis, accounting for about 2% of tuberculosis in all parts of the body. Standard anti-tuberculosis therapy is the fundamental approach to the clinical treatment of spinal tuberculosis, while surgical treatment is also an indispensable means for the clinical treatment of spinal tuberculosis. However, spinal tuberculosis is difficult to cure and prone to relapse, the course of treatment is as long as 1.5~2 years, and there is still 1.3%~25% recurrence rate after surgical treatment. Ossification of the ligamentum flavum (OLF) is an ectopic ossification of the spinal ligament with incidence 3.8% in Chinese population. The onset of OLF is occult with slow progress, which usually leads missed diagnosis, misdiagnosis and delayed treatment, and very high risk of paralysis in the late stage, however, surgical treatment is the only effective treatment for OLF. The OLF secondary to spinal tuberculosis is rarely reported at home and abroad. This paper reports a case of OLF after spinal tuberculosis fusion, and reviews the relevant literature for providing clinical reference.

Abstract:Gorham-Stout disease (GSD) is a sort of idiopathic osteolysis disease, in which with involvement of spine is rare. The diagnose and treatment of GSD are particular challenging as the pathological mechanism is currently unclear and the course of disease is variable. When the osteolysis has resulted in pathological fracture or deformity, early surgical intervention is able to facilitate new bone formation and arrest the progression of osteolysis. In this paper, a patient who was characterized by multiple osteolysis of lumbar spine with deformity was treated by medication and three-time surgical interventions. During the last surgery, the soft tissues adjacent to the damaged vertebrae were diffusively destructed. The massive hemorrhage had forced us to simplify the surgical procedure. With a 26-month follow-up, we observed that the osteolysis and the deformity were halted. The progression potential is high in the GSD with multiple vertebrae involved. Even the deformity is mild, one-stage long-segmental fixation and fusion remains a reliable choice.

Abstract:This review comprehensively summarizes the current status and cutting-edge techniques of tendon allograft processing. The core of tendon allograft processing procedures is outlined, systematically summarizing the research status and advanced technologies in this field. Tendon allografting has become one of the main methods for tendon injury reconstruction. Initially, the application background and developmental trends of tendons allograft are introduced, followed by an in-depth discussion on physical cryopreservation and chemical methods related to immunogenicity and rejection reactions, as well as processing techniques such as defatting and decellularization. Emphasis is placed on the importance of optimizing tendon allograft processing techniques to enhance clinical surgical outcomes, providing scientific evidence and technological support for its clinical application.

Abstract:[Objective] To investigate the biocompatibility and osteogenic properties of acellular bone matrix/calcium phosphate/calcium sulfate hemihydrate (ACBM/CPC/CSH) composite artificial bone. [Methods] ACBM/CPC/CSH composite was synthesized by physical mixing method, and the material extract was prepared for acute and subacute toxicity, pyrogen and epidermal irritation tests. The material was implanted in the muscle and histopathological examination was performed on the 7^th, 14^th and 21^d to observe the inflammatory reaction of the muscle. On the 14^th day, flow cytometry was taken to observe the changes of CD4⁺ and CD8⁺T lymphocyte content in blood and tissues, and the cytotoxicity was detected by CCK-8 method. Bone defect model was established in the rat femoral condyle, and the bone formation was observed by Xray and CT after implantation of ACBM/CPC/CSH group (material group), calcium phosphate/calcium sulfate hemihydrate (CPC/CSH) group (control group) and no material implantation (blank group). [Results] The extract did not cause acute or subacute toxicity in mice, and there was no significant difference in body weight (P＞0.05). In the pyrogen test, the body temperature remained normal. Skin erythema did not appear within 72 h after epidermal injection. In the muscle implantation experiment, there was slight inflammation in the muscle tissue on the 7th day, and the inflammation disappeared on the 21st day. As results of flow cytometry on the 14th day, there were no significant differences among the three groups in terms of the peripheral blood lymphocyte content of CD4⁺ [(9.6±1.8) vs (10.1±1.2) vs (10.7± 1.4), P=0.470], CD8⁺ [(9.5±1.1) vs (10.3±1.8) vs (10.5±1.7), P=0.249], as well as the spleen CD4⁺ [(18.1±1.5) vs (17.2±7.3) vs (17.5±1.0), P= 0.195], and CD8⁺ [(8.8±7.2) vs (7.7±7.6) vs (7.8±7.2), P=0.359]. The X-ray and Micro-CT images showed that bone defects in all groups were repaired to different degrees, and ACBM/CPC/CSH bone materials had the best repair effect. [Conclusion] The ACBM/CPC/CSH composite artificial bone material has good biocompatibility and in vivo osteogenic properties, which is beneficial to the repair of irregular bone defects

Abstract:[Objective] To introduce the surgical technique and primary clinical outcomes of 3D printed polyetheretherketone prosthesis for defect reconstruction secondary to en bloc resection of clavicular malignant tumor. [Methods] A total of 5 patients underwent abovementioned surgical treatment for clavicular malignancy. The lesion involved the lateral segment of the clavicle in 3 cases, while the medial segment in 2 cases, with pathological fracture in 2 cases. After computer modeling based on the shape of the clavicle on the healthy side of the patient, personalized prosthesis and osteotomy guide plate were prepared by 3D printing. The sternoclavicular ligament or acromioclavicular ligament was cut off according to the location of the tumor during the operation, and the osteotomy guide was used to assist the osteotomy on the other side to remove the tumor segment en bloc. The personalized prosthesis prepared by 3D printing was implanted, and connected and fixed with the normal clavicle at the reserved end by using locking plates, with reattachment of the sternoclavicular ligament or acromioclavicular ligament by anchor sutures. [Results] All the patients were successfully operated on without nerve, vascular injury and other complications, got incisions healed in stage I without infection. The patients were followed up for 2 to 26 months, had the shape and function of the shoulder recovered well after the operation. No local tumor recurrence was found during the follow-up period, and no obvious rejection and other complications were observed. [Conclusion] The 3D printed polyetheretherketone prosthesis for defect reconstruction secondary to en bloc resection of clavicular malignant tumor is a feasible technique, and achieves satisfactory clinical consequences in short-term.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of modified transforaminal approach for full endoscopic L₅S₁ decompression of foraminal stenosis. [Methods] A total of 12 patients with L₅S₁ foraminal stenosis were treated by modified foraminal approach with full endoscopic L₅S₁ decompression of foraminal stenosis. The horizontal line of the intervertebral foramina L₅S₁ on the affected side was taken as the puncture path, while the inside of the intersection of the horizontal line and the crest of the iliac crest was used as the puncture needle point. The puncture was carried out to the outside of the junction between the isthmus of L₅ and the apex of the superior articular process of S₁, and then the cannula was inserted, and the isthmus of L₅ and a small part of the apex of the superior articular process of S₁ were removed with an external circular saw under the all-visual endoscope. The protruding nucleus pulposus, hypertrophic ligamentum flavum, or calcified ligamentum flavum pressing on the L₅ nerve root were removed to complete decompression of the L₅ nerve root. [Results] All the patients had operation performed smoothly and got significant improvement in terms of symptoms and function, except 1 who had a tear of the outer nerve root membrane and another had postoperative hip pain, both of them had no serious adverse consequences. During the follow-up period lasted for 6 months to 5 years, no recurrence or worsening of symptoms was found in anyone of them. [Conclusion] Modified transforaminal approach full endoscopic decompression for the treatment of L₅S₁ foraminal stenosis has the advantages of strong repeatability, no restriction of high iliac crest, and no impact on spinal stability.

Abstract:[Objective] To evaluate the clinical efficacy of separation decompression combined with microwave ablation and vertebroplasty in the treatment of spinal metastases complicated with nerve compression. [Methods] A retrospective study was conducted on 26 patients who underwent separation decompression combined with microwave ablation and vertebroplasty for spinal metastasis complicated with nerve compression from March 2018 to June 2023. The operation time, intraoperative blood loss, microwave ablation time and bone cement injection amount were recorded. ASIA neurological scale, visual analogue scale (VAS) for pain, Oswestry disability index (ODI) and Karnofsky performance scale (KPS) were used to evaluate clinical outcomes. In addition, CT and MRI were periodically reviewed to observe the tumor infiltration in the bone and soft tissue around the bone cement in the operative area, and to evaluate the local control of the tumor. [Results] All the 26 patients had operation performed successfully with operation time of (127.3±51.4) min, the intraoperative blood loss of (358.5±241.7) ml, the microwave ablation time of (12.2±3.7) min, and the injected bone cement of (4.7±2.1) ml. However, there was no spinal cord and nerve root injury in anyone of them, with good position of implants and bone cement. The VAS for pain [(8.2±1.4), (3.4±1.1), (2.6±0.6), (2.0±0.5), P＜0.001], ODI [(83.7±11.3), (35.2±7.6), (14.2±2.4), (13.2±2.3), P＜0.001] and KPS scores [(41.7±16.4), (68.4±16.3), (76.4±15.6), (80.2±11.6), P＜0.001] significantly improved as time went preoperatively, 1 month, 3 months and 6 months postoperatively. Furthermore, the ASIA neurological scale significantly improved over time (P＜0.05). At 6 months postoperatively, all patients had tumor well controlled in the operative area without tumor recurrence, except 3 patients who died due to the primary disease. [Conclusion] The separation decompression combined with microwave ablation and verteboplasty do effectively relieve pain, relieve nerve compression and restore spinal stability, control local tumors and improve patients' quality of life.

Abstract:[Objective] To compare the early outcomes of three kinds of anticoagulation treatment during perioperative period of total knee arthroplasty (TKA) in Tibetan patients. [Methods] From January 2021 to July 2021, 60 Tibetan patients who were undergoing TKA were included in this study and randomly divided into three groups by random number table method. Twenty patients in group A received aspirin 25 mg/day; 20 patients in group B received aspirin 100 mg/d; 20 patients in group C were treated with low molecular weight heparin calcium 0.4ml/d for anticoagulation. The results of clinical and color ultrasonography were evaluated. [Results] There were no significant differences in operation time, intraoperative blood loss and total blood loss among the three groups (P＞0.05). Compared with those 1 day postoperatively, VAS scores in the 3 groups were significantly decreased 3 days and 7 days postoperative (P＜0.05), the ROM was significantly increased (P＜0.05), with suprapatellar circumference remained unchanged (P＞0.05). At corresponding time points, there were no significant differences in VAS score, ROM and suprapatellar circumference among the three groups (P＞0.05). In terms of ultrasonography, there was no significant difference in the incidence of thrombus among the three groups (5% vs 5% vs 10%, P＞0.05). [Conclusion] In this study, there was no significant difference in the incidence of early postoperative thrombosis among the 25 mg aspirin, 100mg aspirin and low molecular weight heparin calcium after TKA.

Abstract:[Objective] To compare the clinical consequences of two blood managements during total hip arthroplasty (THA). [Methods] A total of 100 patients who underwent total hip replacement from January 2022 to December 2023 were included in this study. According to the preoperative doctor-patient communication, the patients were divided into multi-mode blood managements group (MMBM) and routine group, with 50 cases in each group. The clinical and laboratory documents of the two groups were compared. [Results] The MMBM group proved significantly superior to the routine group in terms of intraoperative blood loss [(282.0±39.3) ml vs (389.9±46.2) ml, P＜0.001], postoperative drainage volume [(114.5±18.5) ml vs (167.1±13.8) ml, P＜0.001], blood transfusion rate [case (%), 0 vs 6 (12), P=0.027], the drainage time [(35.5±5.1) hours vs (42.2±4.0) hours, P＜0.001] and postoperative hospital stay [(6.8±0.9) days vs (7.5±1.2) days, P=0.002]. Regarding laboratory test, the Hb and Hct significantly decreased in both groups after surgery compared with those before surgery (P＜0.05). Although there was no significant difference in Hb and Hct between the two groups before surgery (P＞0.05), the MMBM group had significantly higher-Hb and Hct than the routine group at all time points postoperatively (P＜0.05). [Conclusion] Multi-mode blood management does effectively reduce the perioperative blood loss and transfusion rate, shorten the postoperative hospitalization, and accelerate the recovery of patients.

Abstract:[Objective] To evaluate the complications of anteroinferior psoasoblique lateral interbody fusion (AIP-OLIF) under direct vision and exposure technique. [Methods] A retrospective study was conducted on 143 patients who received AIP-OLIF from April 2017 to August 2022. The complication and follow-up data were evaluated. [Results] All patients had operation performed successfully with operation time of (238.5±87.7) min, and intraoperative blood loss of (104.1±116.4) ml. Complications in total occurred in 39 patients, accounted for 19.6%. Intraoperative complications occurred in 12 cases (8.4%), including segmental artery injury in 2 cases, peritoneal injury in 2 cases, pleural injury in 2 cases, dural injury in 1 case and endplate injury in 5 cases. Early postoperative complications occurred in 12 patients (8.4%), including 6 patients had pain and numbness in the front of the left thigh on the 1st day after surgery, and 6 patients had mild iliopsoas muscle weakness and quadriceps muscle weakness after surgery, whereas all of them recovered to normal at 1-month follow-up. As time went during follow-up period lasted for (14.8±4.3) months, the VAS score and ODI score were significantly decreased (P＜0.05), while JOA score was significantly increased (P＜0.05). In 15 patients (10.5%), the fusion device subsidence was found in images one year after the operation, all of which remained grade 0 subsidence. [Conclusion] AIP-OLIF can still cause intraoperative and postoperative complications, which should be paid attention to.

Abstract:[Objective] To investigate the accuracy of artificial intelligence (AI) in the measurement of prostheses before total hip arthroplasty (THA). [Methods] A total of 24 patients who were undergoing THA for endstage hip arthropathies from June 2021 to December 2021 were divided into AI group (12 cases) and conventional group (12 cases) according to random number table method. The accuracy and feasibility of AI preoperative planning predicting prosthetic size were analyzed. [Results] There were no significant differences in operation time, total blood loss, postoperative hospitalization days and total hospitalization costs between the two groups (P＞0.05). AI group proved significantly superior to the conventional group in terms of consistency of the acetabular component [(+0/+1/+2), (91.7%/8.3%/0%) vs (33.3%/ 41.7%/25.0%), P=0.013] and the femoral component [(+0/+1/+2), (83.3%/8.3%/8.3%) vs (41.7%/33.3%/25.0%), P=0.017]. With time of follow-up period lasted for (15.2±5.7) months in a mean, the VAS scores significantly decreased (P＜0.05), while hip flexion-extension ROM and Harris scores significantly increased in both groups (P＜0.05), whereas which were not significantly different between the two groups at any corresponding time points (P＞0.05). [Conclusion] This AI preoperative planning has more accurate predictive value than the film template measurement in the selection of prosthetic size before THA.