Abstract:[Objective] To compare the clinical efficacy of debridement and instrumented fusion through anterolateral approach at thelumbar triangle versus conventional posterior approach for lumbar brucellus spondylitis (LBS). [Methods] A retrospective study was conduct-ed on 102 patients who received surgical treatment for LBS in our hospital from January 2017 to October 2022. According to doctor-patientcommunication, 46 patients had operation performed through anterolateral approach at the lumbar triangle (the AL group), while other 56 cas-es were operated through conventional posterior approach (the CP group). The documents regarding to perioperative period, follow-up andimages were compared between the two groups. [Results] All patients in both groups successfully completed the operation. The AL groupproved significantly superior to the CP group in terms of operation time [(163.0±15.4) min vs (200.4±22.6) min, P＜0.001], incision length[(13.0±1.5) cm vs (15.5±2.0) cm, P＜0.001], intraoperative blood loss [(233.0±26.8) ml vs (350.2±30.7) ml, P＜0.001], postoperative ambula-tion time [(3.0±0.5) days vs (4.0±0.8) days, P＜0.001] and hospital stay [(8.6±2.0) days vs (12.5±2.2) days, P＜0.001]. In addition, the formerresumed full weight-bearing activity significantly earlier than the latter [(96.2±7.3) days vs (100.0±10.5) days, P=0.041]. The VAS, ODI,JOA scores and ASIA grades in both groups were significantly improved over time (P＜0.05), and the AL group was significantly better thanthe CP group in VAS scores 3 days postoperatively (P＜0.05), as well as ODI and JOA scores 3 days after operation and at the latest follow-up(P＜0.05). In terms of blood tests, the AL group had significantly lower CRP [(20.5±7.8) mg/L vs (24.8±8.0) mg/L, P=0.008] and ESR [(30.2±9.0) mm/h vs (34.5±10.2) mm/h, P=0.028] than the CP group 3 days postoperatively. [Conclusion] Compared with posterior surgery, the an-terolateral operation at the lumbar triangular for LBS with advantages of less trauma, earlier postoperative ambulation and better improve-ment of lumbar function, is a safe and feasible surgical technique.

Abstract:[Objective] To compare the clinical outcomes of percutaneous curved vertebroplasty (PCVP) with or without manual reduc-tion for osteoporotic vertebral compression fracture non-union (OVCF-NU). [Methods] A total of 90 patients with OVCF-NU admitted toour hospital from June 2020 to September 2022 were divided into two groups by random number table method. Of them, 45 patients receivedPCVP combined with manual reduction (the reduction group), while other 45 patients received PCVP treatment alone without manual reduc-tion(the non-reduction group). The perioperative period, follow-up and imaging data were compared between the two groups. [Results] Thereduction group consumed significantly longer operative time [(40.6±6.7) min vs (36.5±5.6) min, P=0.002], associated with significantlygreater intraoperative X-ray exposure times [(22.0±3.0) vs (20.3±2.5), P=0.004] than the non-reduction group, despite of that there were nosignificant differences in bone cement injection amount, effective bone cement diffusion ratio, bone cement leakage, postoperative ambula-tion time and hospital stay between the two groups (P＞0.05). As time went during the follow-up period lasted for (16.0±2.0) months, the VASscores and ODI score in both groups significantly decreased (P＜0.05). At the last follow-up, the reduction group was significantly better thanthe non-reduction group in term of ODI score [(13.3±3.4) vs (15.0±4.0), P=0.035]. With respect of imaging, the anterior vertebra height ratio,posterior vertebra height ratio and local kyphotic Cobb angle significantly improved in both groups 3 days after surgery and at the last followupcompared with those preoperatively (P＜0.05). The reduction group proved significantly superior to the non-reduction group in terms ofthe anterior vertebral height ratio [(69.5±8.4) vs (65.4±8.2), P=0.024; (68.0±8.0) vs (64.5±7.8), P=0.042], the posterior vertebral height ratio [(84.5±4.0) vs (82.0±3.6), P=0.003; (82.7±4.2) vs (80.2±3.8), P=0.005] at 3 days postoperatively and the last follow-up, as well as the localkyphotic Cobb angle [(11.2±1.8)° vs (12.7±3.0)°, P=0.006] at the last follow-up. [Conclusion] Manual reduction combined with PCVP inthe treatment of OVCF-NU is safe and effective, which can quickly relieve the pain of patients and effectively restore the height and correctthe kyphosis of the injured vertebra.

Abstract:[Objective] To compare the clinical efficacy of endoscopic decompression alone versus traditional open decompression andinstrumented fusion (posterior lumbar interbody fusion, PLIF) in the treatment of degenerative lumbar spondylolisthesis with spinal stenosis.[Methods] A retrospective study was done on 63 patients who received surgical treatment for degenerative lumbar spondylolisthesis with spi-nal stenosis in our hospital from January 2021 to September 2022. According to the doctor-patient communication, 26 patients underwent en-doscopic decompression only (the decompression group), while other 37 patients underwent open PLIF (the fusion group). The perioperativedata, follow-up and imaging results were compared between the two groups. [Results] The decompression group was significantly superior tothe fusion group in terms of operative time [(94.6±24.2) min vs (161.1±26.1) min, P＜0.001], intraoperative blood loss [(19.8±7.5) ml vs(155.4±57.5) ml, P＜0.001], total length of incision [(2.0±0.2) cm vs (7.2±1.2) cm, P＜0.001], intraoperative fluoroscopy times [(2.7±0.7) timesvs (4.5±1.3) times, P＜0.001], drainage volum [(12.2±9.5) ml vs (275.9±171.8) ml, P＜0.001], postoperative ambulation [(3.1±1.0) days vs(15.3±4.4) days, P＜0.001] and hospital stay [(6.9±3.0) days vs (13.2±6.2) days, P＜0.001]. The mean follow-up time was of (14.8±2.7)months, and there was no statistical significance in the time to resume full weight-bearing activities between the two groups (P＞0.05). Astime went on, the VAS score and ODI index of the two groups were significantly decreased (P＜0.05), whereas which were not statistically sig-nificant between the two groups at any corresponding time points (P＞0.05). At 12 months after surgery, there was no significant difference inmodified MacNab grades between the two groups (P＞0.05). As for imaging, there were no significant changes in lumbar lordotic angle in bothgroups after surgery compared with that preoperatively (P＞0.05), which was not statistically significant between the two groups at correspond-ing time points (P＞0.05). [Conclusion] Endoscopic decompression alone achieve satisfactory clinical outcomes similar to those of conven-tional open decompression and instrumented fusion in the treatment of degenerative lumbar spondylolisthesis and spinal stenosis, however,

Abstract:[Objective] To explore the factors affecting spinal development in children with spastic cerebral palsy. [Methods] A total of92 patients with spastic cerebral palsy admitted to our hospital were included into this study to observe the spinal development. Univariatecomparison and multiple regression analysis were used to search the factors related to spinal development. [Results] Among 92 children, 55(59.8%) were sagittal balance, whereas the remaining 37 (40.2%) were found sagittal spinal imbalance. Regarding to univariate comparison,the imbalance group proved significantly greater than the balance group in terms of deviation of sagittal vertical axis (SVA) [(8.2±2.5) cm vs(2.6±1.5) cm, P＜0.001] and lateral displacement of femoral head (migration percentage, MP) [(41.8±17.3)% vs (38.3±19.3)%, P＜0.001], whilethe incidence of epilepsy in the unbalanced group was significantly lower than that in the balanced group [case (%), 0 (0.0) vs 6 (10.9), P=0.038]. There were no significant differences in age, sex, gestational age, birth weight, walking time, number of paralyzed limbs, GMFCSscore, weight, height, BMI and AI between the two groups (P＞0.05). As consequence of paired correlation analysis, the absolute value of SVAwas significantly positively correlated to sex (r=0.231, P=0.027), strabismus (r=0.209, P=0.045), GMFCS scale (r=0.239, P=0.022), MP value(r=0.226, P=0.030), AI value (r=0.217, P=0.038). In addition, multiple linear regression analysis showed that GMFCS scale, gender and AIvalue were factors related to absolute value of SVA (P＜0.05), with a regression equation of Y=-57.715+12.314GMFCS scale +29.204 gender+1.965AI. [Conclusion] As findings of this study, the GMFCS scale, AI value, MP value, sex and strabismus impact spinal development ofchildren with spastic cerebral palsy, and GMFCS grade, sex and AI value might comprehensively predict spinal SVA value of cerebral palsy.

Abstract:[Objective] To investigate the clinical results of two kinds of internal fixation of femoral supracondylar osteotomy for kneeflexion deformity secondary to poliomyelitis. [Methods] A retrospective analysis was performed on 60 patients who received femoral supra-condylar osteotomy for knee flexion deformity due to sequelae of poliomyelitis in our hospital from January 2018 to June 2021. According todoctor-patient communication, 30 cases had osteotomy site fixed by dynamic condyle screw (DCS group), 30 cases were fixed by lockingplate (LP group). The perioperative, follow-up and imaging data were compared between the two groups. [Results] All patients in bothgroups had operation performed successfully. The DCS group proved significantly superior to the LP group in terms of operative time [(54.1±4.3) mim vs (62.5±3.2) min, P＜0.001], total incision length [(13.4±1.0) cm vs (14.6±0.9) cm, P＜0.001], intraoperative blood loss [(39.1±4.0)ml vs (49.8±4.0) ml, P＜0.001], intraoperative fluoroscopy times [(2.8±0.8) vs (3.5±0.8) times, P＜0.001], walk time [(92.9±3.0) days vs (102.3±5.1) days, P＜0.001], hospital stay [(14.7±1.5) days vs (15.8±1.3) days, P=0.002], hospitalization cost [(1.6±0.1) 10k yuan vs (2.4±0.2) 10k yu-an, P＜0.001]. The mean follow-up time lasted for (30.2±7.7) months, and the DCS group resumed full weight-bearing activity significantlyearlier than the LP group [(137.4±5.8) days vs (144.4±3.2) days, P＜0.001]. The VAS scores significantly decreased (P＜0.05), while the kneeextension-flexion range of motion (ROM) and HSS scores significantly increased in both groups over time (P＜0.05), whereas which were notstatistically significant between the two groups at any time points accordingly (P＞0.05). As for imaging, the knee flexion angle decreased sig-nificantly after surgery (P＜0.05), while the FTA angle and K-L grade remained unchanged in both group (P＞0.05). At the matching timepoint, there were no significant differences in knee flexion angle, FTA angle, K-L grade and osteotomy healing between the two groups (P＞0.05). [Conclusion] Femoral supracondylar osteotomy combined with DCS or LP fixation for the treatment of knee flexion deformity due topolio sequela is effective and safe. By comparison, the DCS fixation has advantages of short hospital stay, low cost, early ambulation and rela-tively fewer complications over the LP.

Abstract:[Objective] To compare the clinical consequences of unilateral biportal endoscopy (UBE) versus percutaneous endoscopictransforaminal discectomy (PETD) for lumbar disc herniation. [Methods] A retrospective study was done on 67 patients who received endo-scopic discectomy for lumbar disc herniation from February 2019 to September. According to the results of doctor-patient communication,28 patients were treated with UBE, while other 39 cases were with PETD. The perioperative period, follow-up and imaging data of the twogroups were compared. [Results] All patients in both groups were successfully operated on. The UBE group proved significantly less than thePETD group in terms of operative time [(58.1±10.6) min vs (65.5±11.3) min, P=0.009] and intraoperative fluoroscopy times [(3.1±1.1) timesvs (5.2±1.2) times, P＜0.001]. However, the former was significantly greater than the latter in terms of incision length [(2.3±0.2) cm vs (1.2±0.2) cm, P＜0.001] and the disc volume removed [(3.5±1.1) cm3 vs (2.8±1.1) cm3, P=0.011]. The average follow-up time was (10.5±2.0)months, and there was no significant difference in the time to resume full weight-bearing activities between the two groups (P＞0.05). TheVAS and ODI scores in both groups were significantly improved over time (P＜0.05). The UBE group was significantly superior to the PETDgroup in terms of the lower back pain VAS [(2.3±0.7) vs (2.7±0.6), P=0.028] and ODI [(27.1±4.9) vs (29.7±5.3), P=0.045] one month postoperatively. As for imaging, the Pfirrmann grade of nerve root compression was significantly improved (P＜0.05), and the cross-sectional area ofcanal (CSAC) was significantly increased (P＜0.05), while the CSA of the foraminal area remained unchanged in both groups postoperativelycompared with those preoperatively (P＞0.05). The UBE group was also better than the PETD group regarding postoperative CSAC [(184.4±40.6) mm2 vs (137.0±28.9) mm2, P＜0.001]. [Conclusion] As a new spinal endoscopy technique, unilateral biportal endoscopy has advantag-es of less trauma and full decompression, is conducive to early recovery of patients.

Abstract:[Objective] To evaluate the clinical efficacy of intraaticular injection of adipose-derived stromal vascular fraction (SVF) inthe treatment of knee osteoarthritis (KOA) by meta-analysis. [Methods] The relevant articles published in PubMed and Web of Science be-fore July 29, 2022 were retrieved, and data were extracted after reading the full text. STATA 14.2 software was used for meta-analysis. [Results] This meta-analysis included 12 out of 176 retrieved articles with a total of 401 patients involved. As results of the analysis, the VASscore after treatment (MD=-2.944, 95%CI -3.295~-2.539, P＜0.001), the WOMAC score with follow-up less than 12 months (MD=-16.676,95%CI -17.536 to -15.817, the WOMAC score (MD=-32.940, 95%CI -34.563~-31.317, P＜0.001) at 18 months after the operation was sig-nificantly decreased compared with those before treatment. No serious adverse events repored in any papers. [Conclusion] Based on the lim-ited evidence currently available, SVF injection can reduce VAS and WOMAC scores in patients with KOA in the short term, suggesting thatit is effective for pain and joint dysfunction in patients with KOA without serious adverse events.

Abstract:Spinal epidural lipomatosis (SEL) is a rare disease characterized by the deposition of normal, unencapsulated adipose tissuein the spinal canal. The most common site of SEL is in the lumbosacral spine, which can compress and invade the spinal cord, cauda equina,and nerve roots. This disease has no specific clinical manifestations, and is more likely to be misdiagnosed or missed when the main manifes-tations are perianal tingling and burning sensation. In the past, the main surgical treatment for SEL was posterior open laminectomy and de-compression. In recent years, the development of spinal endoscopy has made minimally invasive treatment of SEL possible. This paper re-ports a case of SEL treated by unilateral biportal endoscopy, and reviews the recent literature on SEL from the aspects of the pathogenesis,clinical manifestations, and treatment.

Abstract:Intervertebral disc degeneration (IDD) is one of the primary causes of low back pain. The pathogenesis of IDD is intricate andinvolves factors such as age, trauma, genetic susceptibility, and autoimmune inflammatory responses. Research indicates that interleukin-17(IL-17A) plays a crucial role in IDD by mediating intra-discal inflammation, promoting extracellular matrix degradation, and accelerating in-tervertebral disc cell apoptosis, thereby expediting the pathological process of IDD. IL-17A is highly expressed in degenerated intervertebraldiscs, suggesting its importance as an inflammatory factor in the pathophysiological processes of IDD. IL-17A induces the production of in-flammatory cytokines, factors related to extracellular matrix degradation, and chemokines, thus promoting the occurrence and developmentof IDD. This article aims to explore the production and function of IL-17A within intervertebral discs and its role in mediating the occur-rence and progression of IDD, offering new insights for the prevention and treatment of IDD.

Abstract:Meniscal tears are becoming increasingly common in orthopedic field. Due to its histological specificity, the torn meniscus isusually treated conservatively or surgically to prevent the development of osteoarthritis. Because the meniscus lacks blood supply and is nonrenewable,whether it is traumatic or degenerative tear the meniscectomy will lead to the occurrence of later osteoarthritis. With the rise of3D printing technology, it has brought hope to meniscus repair. Of course, 3D printing requires highly sophisticated instruments and thepreparation of 3D printing inks with excellent properties. This review provides an in-depth discussion of the different bioinks currently usedfor bioprinting and outlines prospects for their further development. In addition, bacterial cellulose, which was found to be a 3D printing inkwith good performance, is introduced in this paper.

Abstract:[Objective] To observe the effects of different duration of exercise on the isokinetic strength of knee extensor and flexor.[Methods] A total of 54 college students were included into this study and divided into 5 groups by random number method. Of them, 11 per-sons were in the 10-second group, 11 in the 15-second group, 11 in the 20-second group, 10 in the 25-second group and 11 in the 30-sec-ond group, and corresponding duration of knee exercises conducted for 12 weeks. The Biodex S4 isokinetic test system was used to measurepeak torque (PT), relative peak torque (peak torque / body weight, PT/BW), average power (AP) and hamstring / quadriceps (H/Q) at angularspeeds of 60°/s and 180°/s before and 12 weeks after exercise. [Results] In term of extensor, the PT and PT/BW were significantly increasedin all the 5 groups (P＜0.05), and AP were significantly increased in the 10-second group, 15-second group, 20-second group and 30 secondgroup at 60°/s angular velocity 12 weeks after exercise compared with those before exercise (P＜0.05). Furthermore, the PT, PT/BW and APwere significantly increased in the 10-second group, 20-second group and 30-second group at 180°/s angular velocity (P＜0.05), with themost significant changes in the 20-second group and 30-second groups. There was no significant difference in the above indexes among the5 groups at any corresponding time point (P＞0.05). In term of flexor, the PT and PT/BW were significantly increased in the 10-second group,15-scond group, 20-second group and 30 second groups (P＜0.05), and AP was significantly increased in the 15-second group, 20-secondgroup and 30-scond groups at 60°/s angular velocity (P＜0.05), while the PT, PT/BW and AP in 10-second, 20 second and 30-second groupswere significantly increased at 180°/s angular velocity (P＜0.05). However, there were no significant changes in H/Q before and after exercise in all the 5 groups (P＞0.05), and there were no significant differences in H/Q among the five groups at any corresponding time points (P＞0.05). [Conclusion] Traditional exercises does improve the maximum muscle strength, explosive power and muscle endurance of knee exten-sor and flexor. Among them, exercises lasting 20 seconds and 30 seconds have the most significant improvement in knee extensor and flexorstrength.

Abstract:[Objective] In three-dimensional models with the bony landmarks consistent with the endoscopic observation, the parame-ters related to L4 outlet nerve root accurately located and safely decompressed was measured for assistance of one-hole split endoscope.[Methods] On the 3D lumbar models of 34 patients with L4/5 unilateral far lateral lumbar disc herniation constructed based on CT, the param-eters in the sagittal plane according to the intersection of the lower margin of the L4 transverse process root with the lateral margin of the isth-mus (ITPI) were measured, including the vertical distance from the ITPI to the upper margin of L4 outlet nerve root (UMNR-L4), the verticaldistance of the lower margin of L4 outlet nerve root (LMNR-L4), the anteroposterior horizontal distance of the posterior margin of L4 outletnerve root (PMNR-L4), the vertical distance of the L4 inferior endplate (IEP-L4), the vertical distance of the L5 upper endplate (UEP-L5), ver-tical distance of the pedicle lower margin of L4 pedicle (LMP-L4), and so on. The data were compared between two genders and two sides.[Results] In term of the lower margin of L4 outlet nerve root projected above the L4/5 intervertebral space, the healthy side was smaller thanthat of the affected side [4/34 (11.8%) vs 18/34 (52.9%)]; while the proportion of healthy side was larger than that of the affected side [30/34(88.2%) vs 12/34 (35.3%)] when projected within the L4/5 intervertebral space. There were no significant differences between two genders andtwo sides in terms of the vertical distance between ITPI and the upper edge of L4 outlet nerve root, the vertical distance between lower edge ofL4 outlet nerve root, the horizontal distance between anterior and posterior edge of L4 outlet nerve root, the vertical distance between lowerend plate of L4, the vertical distance between upper end plate of L5 and the vertical distance between lower edge of L4 pedicle, the left and right horizontal distance of ITPI to the outermost edge of the L4 inferior endplate, the vertical distance of the upper edge of the L4 outlet nerveroot on the sagittal plane, the vertical distance of the lower edge of the L4 outlet nerve root, the vertical distance of the L4 inferior endplate,the vertical distance of the L5 upper endplate located in ITPI, and the left and right horizontal distance of the medial wall of the L4 pedicleand the left and right horizontal distance of the lateral border of the dura (P＞0.05). There were no significant correlations among the mea-sured parameters to age and BMI (P＞0.05). [Conclusion] As the intersection of the lower margin of the L4 transverse process root with the lat-eral margin of the isthmus was used as the bony landmark, there was no need to explore upward, but only part of the bone is removed outwardand downward to expose and decompress the L4 outlet nerve root safely.

Abstract:[Objective] To investigate the clinical outcomes of foot osteotomy combined with Ilizarov technique in the treatment of de-nervated foot stiffness deformity complicated with ulcer. [Methods] A retrospective study was conducted on 20 patients (24 feet) who re-ceived surgical correction for denervated foot stiffness deformity complicated with ulcer in our hospitals from April 2019 to December 2022.All the patients underwent Achilles's tendon lengthening, tendon transfer and triple hindfoot osteotomy, followed by Ilizarov frame installed.The external frame was adjusted to gradually correct the residual deformity of the foot 5~7 days after operation, with dressing changed regu-larly after debridement of the foot ulcer. Two patients with Wanger grade IV ulcer received lateral tibial distraction simultaneously. Clinicaland imaging results were evaluated. [Results] All patients had operation performed smoothly, with the average external fixator adjustmenttime of (23.3±5.4) days, the average healing time of foot ulcer of (22.6±5.2) days, and the average wearing time of external fixator of (99.3±14.4) days. All the patients were followed up for a mean of (2.3±0.9) years. With time preoperatively, 3 months postoperatively and at the lastfollow-up, the VAS score significantly reduced [(3.2±0.4), (0.4±0.2), (0.3±0.2), P＜0.001], while the AOFAS score significantly increased[(37.8±3.9), (78.4±4.0), (88.3±4.0), P＜0.001]. Regarding imaging, the tibiocalcaneal angle (TCA) [(123.2±8.4)°, (63.7±1.6)°, (63.6±1.6)°, P＜0.001], Meary angle [(38.3±6.0)°, (3.6±1.0)°, (3.5±0.7)°, P＜0.001] were significantly reduced over time points abovementioned, and all pa-tients got osteotomy healed 3 months after surgery. [Conclusion] Triple hindfoot osteotomy combined with Ilizarov technique is safe, reliablemethod and achieves satisfactory short-term consequence for treatment of denervated foot stiffness deformity complicated with ulcer.

Abstract:[Objective] To investigate the clinical effect of posterior percutaneous large channel endoscopic laminectomy and decom-pression in the treatment of cervical spondylotic radiculopathy. [Methods] A retrospective study was conducted on 32 patients who recervedabovementioned surgical procedure for cervical spondylotic radiculopathy from January 2021 to December 2022. The clinical and imagingdata were evaluated. [Results] All the 32 patients had operation performed successfully without serious complications, with the average oper-ation time of (39.3±5.8) min, average intraoperative blood loss of (15.6±5.4) ml, and followed up for (16.4±3.5) months in a mean. As timeelapsed from the point preoperatively, 3 days after surgery to the last follow-up, the neck and shoulder pain VAS score [(6.7±1.0), (2.2±0.5),(1.3±0.4), P＜0.001], upper limb pain VAS score [(7.4±0.8), (2.3±0.9), (1.3±0.5), P＜0.001] and NDI score [(39.±2.4), (17.7±1.8), (10.7±1.7),P＜0.001] significantly declined, whereas JOA score [(7.3±1.7), (16.4±2.6), (22.63±2.3), P＜0.001] increased significantly. In terms of imag-ing, the responsible segment vertebral canal area [(1.6±0.1) mm2, (1.9±0.1) mm2, (2.0±0.1) mm2, P＜0.001] was significantly increased 3 dayspostoperatively and at the last follow-up compared with that preoperatively, while the intervertebral space height and cervical lordosis angleslightly increased, but without statistically significant differences (P＞0.05). [Conclusion] Posterior percutaneous large-channel endoscopiclaminectomy is a safe and effective surgical method for the treatment of cervical spondylotic radiculopathy.

Abstract:[Objective] To investigate effect of bone-filling mesh container (BFMC) in percutaneous kyphoplasty (PKP) on bilateral bonecement injection and leakage for osteoporotic compression fracture (OVCF). [Methods] A retrospective analysis was performed on 100 pa-tients who received single-segment bilateral PKP in our department from 2022.10 to 2023.7. According to doctor-patient communication, 50of them received BFMC-PKP (the BFMC group), while other 50 received routine bilateral PKP (PKP group). Early clinical results with imag-ing data were compared. [Results] The bone cement injection volume in the BFMC side group was significantly higher than that in PKP side inthe BFMC group [(4.8±0.8) ml vs (2.6±0.6) ml, P＜0.001], while the amount of bone cement injected in the BFMC side was also significantlyhigher than that in PKP group [(4.8±0.8) ml vs (4.1±0.9) ml, P=0.030]. The VAS scores significantly declined in both groups 3 days postopera-tively compared with that preoperatively (P＜0.05), whereas which was not significantly different between the two groups at any time points ac-cordingly (P＞0.05). Bone cement leakage rate on BFMC side was significantly lower than that in PKP side in the BFMC group [case (%), 5(10.0) vs 20 (40.0), P＜0.001], and which on BFMC side in the BFMC group was significantly lower than that in PKP group [case (%), 5 (10.0) vs14 (28.0), P=0.020] . Most of the bone cement leakage occurred in the upper endplate, lateral and anterior sides. The anterior vertebral heightof injured vertebrae increased significantly (P＜0.05), while the local kyphotic angle decreased significantly in both groups postoperatively com-pared with those preoperatively (P＜0.05). [Conclusion] In PKP for OVCF, BFMC can significantly reduce the bone cement leakage on the ipsi-lateralside,butleadtoadecreaseintheamountofbonecementinjectionandanincreaseintheleakagerateonthecontralateralside.

Abstract:[Objective] To compare the clinical efficiency of percutaneous vertebroplasty (PVP) under guidance of CT versus fluorosco-py for osteoporotic vertebral compression fracture (OVCF) in the elderly. [Methods] From May 2019 to May 2021, 80 elderly patients withOVCF who underwent PVP surgery were included in this study, and randomly divided into two groups by lottery. Of them, 40 patients hadPVP performed under CT (CT group), while the other 40 patients underwent PVP under fluoroscopy with C-arm X-ray machine (fluoroscopygroup). The documents regarding perioperative period and images were compared between the two groups. [Results] All patients in bothgroups had PVP performed successfully. The CT group proved significantly superior to the fluoroscopy group in terms of operation time[(45.6±1.7) min vs (69.2±2.0) min, P＜0.001], intraoperative X-ray exposure times [(16.8±0.9) vs (38.6±2.6), P＜0.001] and puncture time[(23.2±1.5) min vs (46.2±2.1) min, P＜0.001], and success rate of first puncture [cases (%), 32 (80.0) vs 26 (65.0), P＜0.001]. However, therewas no significant difference in bone cement leakage rate between the two groups (P＞0.05). All the patients were followed up for 2 to 12months, and the VAS and ODI scores were significantly decreased in both groups at discharge compared with those before surgery (P＜0.05),whereas which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Regarding imaging, therewere no significant differences in anterior vertebral height (AVH) and local kyphotic angle (LCA) between the two groups at discharge (P＞0.05). [Conclusion] The CT-guided PVP does significantly shorten the operation time, reduce the number of intraoperative fluoroscopy, andmonitor the bone cement injection process in real time, might take more advantage for the elderly with severe osteoporosis.

Abstract:腰椎微创减压术，并发症，硬膜外血肿

Abstract: