Abstract:[Objective] To compare clinical efficacy of supramalleolar osteotomy (SMOT) with plate internal fixation (IF) versus external fixation (EF) by distracting Ilizarov frame for traumatic ankle varus deformity (TAVD) in adolescents. [Methods] A retrospective analysis was performed on 30 adolescent patients with TAVD treated in our hospital from February 2015 to February 2022. According to doctor-patient communication, 16 patients had SMOT with IF of anatomical plate, while other 14 patients were treated with SMOT with EF of distracting Ilizarov frame. The perioperative, follow-up and imaging data of the two groups were compared. [Results] The IF group proved significantly superior to the EF group in terms of operation time [(90.0±11.6) min vs (102.1±9.1) min, P=0.004] and hospital stay [(13.3±4.4) days vs (18.5±5.3) days, P=0.007], whereas significantly inferior to the EF group in terms of intraoperative blood loss [(156.9±46.7) ml vs (90.7± 14.4) ml, P＜0.001], total incision length [(14.5±2.3) cm vs (4.6±0.8) cm, P＜0.001], and postoperative ambulation time [(71.7±16.7) days vs (5.6±2.3) days, P＜0.001]. The mean follow-up period lasted for (20.6±3.5) months on an average, and the VAS and AOFAS scores in both groups were significantly improved over time (P＜0.05). Morever, the IF proved significantly better than the EF group regarding VAS score 6 months postoperatively [(1.3±1.3) vs (2.6±1.6), P=0.023]. Regarding image, talus title (TT), tibial anterior surface angle (TAS), and Takakura scale were significantly improved in both groups after surgery compared with those preoperatively (P＜0.05). The IF group was significantly superior to the EF group in terms of TAS [(89.8±1.4)° vs (87.6±3.4)°, P=0.036] and Takakura grade [0/I/II/IIIa/IIIb/IV, (2/11/3/0/0/0) vs (0/7/ 6/1/0/0), P=0.038] 3 months after surgery. [Conclusion] Both fixation methods in SMOT are effective in the treatment of juvenile TAVD.Compared with internal fixation, the external fixation has advantages of less surgical trauma, less bleeding, early weight-bearing activities, avoiding bone grafting, etc., whereas it has disadvantages such as longer operation time, longer hospital stay, more intraoperative fluoroscopy, and greater pain for patients.

Abstract:[Objective] To investigate the effect of preoperative knee varus deformity on the outcomes of total knee arthroplasty (TKA). [Methods] A retrospective study was conducted on 86 patients who received TKA for knee osteoarthritis in our hospital from April 2020 to April 2022. According to the preoperative hip-knee-ankle angle (HKAA), 54 patients had mild knee varus (≤10°), while the remaining 32 patients had moderate knee varus deformity (10°~20°). The correlation between lower limb alignment and clinical score was analyzed. [Results] All patients in both groups had TKA performed successfully without serious complications, and with no significant differences regarding perioperative data between the two groups (P＞0.05). The VAS, WOMAC and HSS scores, as well as knee extension-flexion ROM significantly improved in both groups over time postoperatively (P＜0.05). The mild group proved significantly better than the moderate group in terms VAS, WOMAC and HSS scores, as well as knee extension-flexion ROM before operation and 3 months postoperatively (P＜0.05). Radiographically, the mild group proved significantly superior to the moderate group in terms of femorotibial angle (FTA) [(190.4±5.6)° vs (196.3±6.1)°, P＜ 0.001], medial proximal tibial angle (MPTA) [(73.4±3.8)° vs (67.2±3.1)°, P＜0.001], posterior tibial slope (PTS) [(8.5±1.9)° vs (7.2±1.6)°, P= 0.002], mechanical axis deviation (MAD) [(38.4±1.5) mm vs (40.6±2.1) mm, P=0.002] before TKA; additionally FTA [(174.3±4.1)° vs (180.7± 5.3)°, P＜0.001], MPTA [(87.6±5.3)° vs (79.3±4.5)°, P＜0.001] regardless of that there was no significant difference in PTS and MAD between the two groups (P＞0.05) postoperatively. As results of Pearson correlation analysis, preoperative FTA was significantly positively correlated to VAS scores (r=0.416, P=0.014) and WOMAC scores (r=0.545, P＜0.001), whereas negatively correlated with ROM (r=-0.545, P＜0.001). In addition, the preoperative MPTA was significantly negatively correlated to VAS scores (r=-0.452, P=0.008) and WOMAC scores (r=-0.578, P＜0.001), whereas significantly positively correlated to ROM (r=0.614, P＜0.001). However, there were no correlation between FTA, or MPTA with VAS, WOMAC score and ROM at the last follow-up (P＞0.05). [Conclusion] The extent of knee varus deformity before surgery has considerable effect on the lower limb alignment after TKA, but has little effect on knee joint motion and knee function.

Abstract:[Objective] To investigate the related factors for the formation of deep vein thrombosis (DVT) after lower limb joint replacement following accelerated rehabilitation. [Methods] A total of 330 patients who underwent lower limb joint replacement following accelerated rehabilitation in our hospital from December 2021 to December 2022 were included in this study to observe whether postoperative DVT occurred. The univariate comparison and multifactor binary logistic regression analysis was used to explore the factors related to DVT formation. [Results] Among the 330 patients, 46 patients were diagnosed with lower extremity deep vein thrombosis after operation, with the overall incidence of 13.9%. The DVT group proved significantly greater than the non-DVT group in terms of age [(71.9±7.2) years vs (64.4±14.2) years, P＜0.001], the proportion of females [male/female, (7/39) vs (84/200), P=0.046], the proportion of previous cerebral infarction [yes/no, (12/34) vs (32/252), P=0.006] and proportion of disease as OA [CD/ON/OA/RA/FX, (5/2/35/0/4) vs (42/50/157/10/25), P=0.048], preoperative CRP [(9.3±8.2) mg/L vs (3.5±3.2) mg/L, P＜0.001], CRP a day postoperatively [(21.4±18.5) mg/L vs (14.7±12.8) mg/L, P=0.004]. However, the former had significantly less intraoperative blood loss than the latter [(322.2±225.4) ml vs (432.9±298.6) ml, P=0.005]. The DVT group had significantly higher ratio of UKA, TKA, and AFHR than the non-DVT group [UKA/TKA/AFHR/THA, (13/22/2/9) vs (67/82/10/ 125), P=0.013]. As results of multivariate logistic regression, the alcohol consumption history (OR=5.041, P=0.046), preoperative CRP (OR= 1.173, P=0.031), and age (OR=1.078, P＜0.001) were the independent risk factor for DVT after lower limb joint replacement. [Conclusion] After lower limb joint replacement following accelerated rehabilitation, the incidence of other types of deep vein thrombosis of lower limb is low except for intermuscular vein thrombosis. Alcohol consumption history, preoperative CRP and age are independent risk factors for DVT after lower limb joint replacement.

Abstract:[Objective] To evaluate the clinical value of robot-assisted posterior vertebral column resection (PVCR) and pedicle screwrod system for correction of severe idiopathic scoliosis (AIS) in adolescent. [Methods] A retrospective study was performed on 26 patients who received PVCR with pedicle screw-rod correction of severe AIS from September 2018 to June 2022. According to preoperative doctorpatient communication, 11 patients underwent robotassisted pedicle screw placement (the robot group), while other 15 patients had the screws placed by conventional free-hand technique (the free-hand group). Clinical and imaging data were compared between the two groups. [Results] All the patients had operation performed successfully with a total of 28 segments of PVCR conducted in the two groups, with a total of 242 screws placed in the robot group, whereas 311 screws inserted in the free-hand group. No serious complications such as spinal cord injury and death occurred in anyone of both groups during the operation. Although the robot group consumed significantly longer operation time than the free-hand group [(760±43.8) min vs (637.3±37.9) min, P＜0.001], the former had significantly less intraoperative fluoroscopy times than the latter [(10±1.7) times vs (18.8±1.5) times, P＜0.001], and there was no significant difference in intraoperative blood loss between the two groups (P＞0.05). All patients in both groups were followed up for more than 12 months, and got considerable improvement in terms of trunk balance, height and sitting height, as well as life and exercise ability postoperatively, with no significant loss of deformity correction, and no surgical revision in both groups. Radiographically, the robot group proved significantly superior to the free-hand group regarding the accuracy of screw placement [(95.1±2.1)% vs (85.6±3.3)%, P＜0.001]. Compared with those preoperatively, the Cobb angle of coronal main curvature, Cobb angle of sagittal kyphosis, C₇PL-CSVL and SVA were significantly decreased in both groups after operation (P＜ 0.05), while which were not statistically significant between the two groups at any corresponding time points (P＞0.05). [Conclusion] The PVCR considerably facilitates correction of severe AIS. The intraoperative robot-assisted pedicle screw placement does effectively improve the accuracy, despite learning curve and time consuming in the initial stage.

Abstract:[Objective] To investigate the clinical value of serum β-galactoside-binding soluble 3 (LGALS3) in the diagnosis of nontraumatic osteonecrosis of the femoral head (NONFH). [Methods] From April 2023 to September 2023, 84 NONFH patients were enrolled as necrosis group, while other 78 healthy subjects were selected as control group. The serum LGALS3 concentration in the two groups were detected by enzyme-linked immunosorbent assay, and related clinical data were collected, including gender, age, body mass index (BMI), smoking history, NONFH etiology, number of affected sides, visual analogue scale (VAS) for pain, Harris score, and ARCO staging. The LGALS3 concentration and its relationship with clinical parameters in the groups divided by different facots were compared and analyzed. [Results] The serum LGALS3 concentration in the necrotic group was significantly higher than that in healthy group [(9.8±7.7) ng/ml vs (4.2± 4.1) ng/ml, P＜0.001]. In patients with NONFH, LGALS3 concentration was significantly higher in the bilateral affected than in the unilateral involved [(14.7±8.1) ng/ml vs (5.3±3.3) ng/ml, P＜0.001], the femoral head collapsed was significantly higher than the non-collapsed [(13.5± 7.3) ng/ml vs (3.1±1.2) ng/ml, P＜0.001]. Based on ARCO staging, the concentration of LGALS3 gradually increased from stage I to stage IV, with statistically significant differences among the subgroups [(2.1±1.0) ng/ml vs (4.1±1.3) ng/ml vs (11.0±5.8) ng/ml vs (16.8±8.2) ng/ml, P＜ 0.001]. LGALS3 concentration in NONFH patients was significantly positively correlated with VAS score (r=0.843, P＜0.001), whereas was significantly negatively correlated with Harris score (r=-0.710, P＜0.001), and positively correlated with ARCO stage (r=0.822, P＜0.001). ROC analysis showed that the area under curve (AUC) of LGALS3 concentration predicting NONFH was of 0.769. [Conclusion] Serum LGALS3 can reflect the severity of NONFH, and may be a potential biomarker for early diagnosis of the disease.

Abstract:[Objective] To compare the clinical efficacy of posterior lumbar interbody fusion (PLIF) with unilateral versus bilateral pedicle screws fixations for lumbar degenerative diseases. [Methods] A retrospective study was done on 90 patients who received PLIF for lumbar degenerative diseases in our hospital from August 2018 to June 2021. According to preoperative doctor-patient communication, 48 patients underwent unilateral fixation, while other 42 patients underwent bilateral fixations. The perioperative period, follow-up and imaging documents were compared between the two groups. [Results] The unilateral group proved significantly superior to the bilateral group in terms of operation time [(108.3±10.7) min vs (155.8±17.1) min, P＜0.05], intraoperative blood loss [(121.2±18.4) ml vs (186.7±18.3) ml, P＜ 0.05] and hospital stay [(10.2±3.4) days vs (11.8±3.7) days, P＜0.05], despite statistically insignificant differences in incision length, intraoperative fluoroscopy times, walking time and incision healing grade between the two groups (P＞0.05). The average follow-up time was (29.1± 6.2) months, and there was no a significant difference between the two groups in the time to return to full weight-bearing activities (P＞0.05). The VAS scores of low back pain and leg pain, as well as ODI and JOA scores significantly improved in both groups over time (P＜0.05). At 6 months after surgery, the unilateral group was significantly better than the bilateral group regarding to ODI [(25.5±6.2)% vs (28.5±7.4)%, P＜ 0.05] and JOA scores [(20.5±2.2) vs (19.6±1.8), P＜0.05] regardless of insignificant difference in VAS score between the two groups (P＞0.05), whereas all abovesaid clinical scores became not statistically significant between the two groups at the last follow-up (P＞0.05). Radiologically, the vertebral space height and lordotic Cobb angle significantly improved in both groups at 6 months after surgery and at the last followup compared with those preoperatively (P＜0.05). However, there were no statistically significant differences in the above image indexes and fusion rate between the two groups at any time points correspondingly (P＞0.05). [Conclusion] The unilateral pedicle screw fixation PLIF does restore spinal stability, restore spinal function and reduce surgical injury in this study.

Abstract:Legg-Calvé-Perthes disease (LCPD) is a rare disease characterized by avascular necrosis of the femoral head that occurs specifically in children, with unknown etiology and insidious onset. With the progression of the disease, it is prone to develop into coxa plana or even severe hip osteoarthritis in adulthood due to poor head and acetabulum matching or even acetabular inversion. The adult with coxa plana secondary to LCPD is difficult to treat, and often have to accept total hip arthroplasty. This article reports a case of adult coxa plana and severe osteoarthritis secondary to LCPD, and reviews the research progress related to LCPD.

Abstract:Steroid-induced osteonecrosis of the femoral head (SONFH) is a style of pathology characterized by osteocyte ischemia, necrosis and trabecular fracture and femoral head collapse. The end-stage SONFH with clinical manifestations of pain and joint dysfunction is a disabling and refractory orthopedic disease. This disorder has complex pathogenesis, often manifested by the combination or cross-action of multiple pathways. In this review, the pathogenesis and related signaling pathways of SONFH were reviewed in order to further understand the pathogenesis and prevention of SONFH.

Abstract:Hip replacement is an effective treatment for end-stage hip diseases such as femoral head necrosis. Reasonable planning before operation, correct placement of prosthesis during operation and regular follow-up after operation are essential for successful operation and early detection of prosthetic abnormalities. However, a large amount of repetitive work will inevitably consume doctors' valuable time, and there are subjective differences in the understanding of the results among different doctors, which may lead to the delay of the disorder. In recent years, artificial intelligence has been deeply integrated with hip replacement, which is expected to reduce the burden on doctors and promote the precision of hip replacement. This paper reviews the progress of artificial intelligence in the field of hip replacement in recent 10 years. Firstly, the current development status of artificial intelligence is summarized. Secondly, the status quo before, during and after the replacement is described. Finally, it analyzes the shortcomings of artificial intelligence in this field, and predicts the future focus points and trends.

Abstract:Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with histological features between hemangiomas and highgrade angiosarcomas. Because its imaging and histological features are similar to hemangiomas or metastatic spinal tumors, accurate diagnosis and effective treatment of spinal EHE are particularly important. From some of the reported spinal EHE, we can note that there are certain similarities in its diagnosis and treatment, and this article reports one case of spinal EHE, and reviews and summarizes the published literature on spinal EHE.

Abstract:[Objective] To measure the morphological parameters of scapular glenoid on CT data by MIMICS software, and compare the differences between left and right side and between male and female. [Methods] A analysis was conducted on the data of bilateral shoulder CT scan obtained in 84 normal adults from August 2022 to July 2023. The subjects included 45 males and 39 females, aged 18 to 86 years with an average age of (53.8±17.9) years. CT data were imported into MIMICS software for 3D reconstruction, and the concave surface of scapular glenoid, the planes of scapular outline and glenoid outline were determined. Anatomic parameters were measured, including the height, width, height-width ratio, superoinferior (SI) depth, anteroposterior (AP) depth, SI/AP ratio, area of concave glenoid surface (ACGS) and glenoid inclination. [Results] There were no significant differences in height, width, height width ration, SI depth, AP depth, SI/AP depth ratio, ACGS and glenoid inclination between the left and right sides in the 45 adult males and 39 females (P＞0.05). However, the male was significantly greater than the female in terms of glenoid height [(37.2±2.4) mm vs (32.6±2.4) mm, P＜0.001], width [(28.5±2.8) mm vs (23.2±2.3) mm, P＜0.001], and SI depth [(3.6±0.9) mm vs (3.3±1.0) mm, P=0.013], AP depth [(2.0±0.7) mm vs (1.7±0.8) mm, P=0.036], ACGS [(820.6±116.1) mm² vs (627.9±86.0) mm² , P＜0.001] and absolute value of glenoid inclination [(13.8±7.1)° vs (10.7±4.5)°, P＜0.001], whereas the male had significantly less height/width ratio than the female [(1.3±0.1) vs (1.4±0.1), P＜0.001], and there was no a significant difference in the SI/AP depth ratio between the two genders [(2.2±0.8) vs (2.3±1.4), P=0.629] on the left side. In addition, totally same anatomic differences were verified on the right side between the male and female. [Conclusion] The MIMICS software used to measure the morphological parameters of scapular glenoid is accurate, quick and visible. The data of this study might provide reference for the evaluation of anatomic abnormality in glenohumeral instability.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of computer aided design (CAD) assisted cervicothoracic hemivertebrae resection and deformity correction. [Methods] From January 2016 to December 2020, 14 patients with congenital cervicothoracic hemivertebra malformations were treated with CAD assisted cervicothoracic hemivertebra resection and deformity correction. Mimics software was used to perform orthopedic design and simulate the orthopedic process before surgery. Under neuroelectro-physiological monitoring system used during surgery to ensure the safety of surgical correction, pedicle screws were precisely inserted according to the preoperative design, half vertebra was removed, and the scoliotic deformity was corrected by pedicle screw-rod system. The brace was worn after operation to maintain the correction effect. [Results] All patients were successfully operated, with no serious vascular, nerve and organ injuries and other complications. A total of 140 pedicle screws were inserted, with an accuracy of 97.1%. Compared with those preoperatively, the cervicothoracic scoliotic angle [(53.9±17.9)°, (11.5±2.5)°, P＜0.001], the kyphotic angle [(27.8±9.8)°, (10.7±1.6)°, P＜0.001] significantly improved at the latest follow-up lasted for (35.5±13.2) months. In addition, the torticollis angle, T₁ inclination and clavicular angle were significantly reduced postoperatively (P＜0.05). No loss of correction, pseudoarthrosis and loosening of internal fixation occurred in anyone of them during follow-up. [Conclusion] The CAD assisted cervicothoracic hemivertebra resection and deformity correction are safe and effective to insert pedicle screws and complete hemivertebra resection accurately, and improve surgical efficiency.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic osseous sulcus deepening and tendon sheath tightening for chronic peroneal tendon slipping. [Methods] Two patients underwent abovementioned surgery for chronic peroneal tendon slippage. As the posteromedial, posterolateral and posterolateral lower portals were established, the hyperplastic synovial tissue was debrided to reveal the peroneal tendon sheath and osseous sulcus. Under the direct vision of the arthroscope, the belly of peroneal brave extended to the distal end were removed, the osseous sulcus was deepened with a bur, and the peroneal tendon sheath were tightened with supra-peroneal retinaculum. [Results] Both the patients were successfully operated on. The ankle joint function was significantly improved after operation, with AOFAS score of 92 and 94, while the pain VAS score of 0, and the physical activity completely restored, whereas tendon slip did not recur. [Conclusion] The arthroscopic osseous sulcus deepening and tendon sheath tightening is safe, minimally invasive, low complication risk, and archives good outcome for chronic peroneal tendon slipping.

Abstract:[Objective] To investigate the clinical effect of posterior hemivertebrae resection and short segment instrumented fusion for congenital spinal malformations in children. [Methods] A retrospective study was conducted on 21 children who received posterior hemivertebra resection and short segment instrumented fusion for congenital hemivertebra malformation from December 2016 to June 2020. The clinical and imaging data were evaluated. [Results] All the patients had operation performed successfully with no serious complications such as neurovascular injury, while with operation time of (199.3±10.7) min, intraoperative blood loss of (491.4±74.1) ml and fusion segments of (2.8±0.2). Regarding imaging, compared with those preoperatively, the coronal Cobb angle [(37.7±2.2)°, (10.7±2.0)°, (10.1±2.0)°, P＜0.001], local scoliotic Cobb angle [(32.8±2.0)°, (7.2±1.8)°, (6.1±1.6)°, P＜0.001], top vertebrae migration [(22.4±2.8) mm, (11.3±1.5) mm, (7.2±0.9) mm, P＜0.001], cephalad contralateral compensatory [(15.9±1.9)°, (6.2±1.1)°, (4.7±0.8)°, P=0.002], caudal compensatory [(18.6±1.8)°, (7.8± 1.3)°, (5.7±1.1)°, P＜0.001], and local kyphotic angle [(19.0±3.0)°, (7.9±1.4)°, (7.3±1.4)°, P＜0.001] significantly reduced immediately postoperatively and at the latest followup. [Conclusion] Single posterior hemivertebra resection and short-segment instrumented fusion for congenital scoliosis deformity in children have advantages of short operation time, less intraoperative bleeding, satisfactory correction, do achieve good clinical consequences.

Abstract:[Objective] To investigate the clinical outcomes of osteochondral autografting through medial malleolus "V" shaped osteotomy approach for osteochondral lesions of the talus (OLT). [Methods] A retrospective study was conducted on 24 patients who received osteochondral autografting through medial malleolus "V" shaped osteotomy approach for OLT from January 2018 to June 2020. The clinical and imaging documents were evaluated. [Results] All the patients were successfully operated on without nerve or vascular injury, with average operation time of (71.4±12.0) min, and intraoperative blood loss of (39.2±11.2) ml, and were followed up for (24.2±6.6) months. Compared with those preoperatively, the VAS score for pain [(6.1±0.7), (1.0±0.9), (0.9±0.6), P＜0.001], AOFAS ankle and hindfoot scores [(66.8±4.8), (89.5±5.4), (93.0±5.1), P＜0.001] significantly improved, while knee Lysholm scores were not significantly changed at 1 year after surgery and the latest follow-up (P＞0.05). In term of imaging, the magnetic resonance observation of cartilage repair tissue (MOCART) score [(43.3± 7.0), (66.5±7.1), (69.2±6.5), P＜0.001] significantly increased, and all patients got osteotomy healed and OLT lesions repaired well, with the Takaku ankle degeneration grade unchanged significantly (P＞0.05). [Conclusion] The osteochondral autografting through medial malleolus "V" shaped osteotomy approach is safe and reliable in the treatment of osteochondral lesions of the talus.

Abstract:[Objective] To present the preliminary results of periosteal stretching in the treatment of diabetic foot. [Methods] A retrospective study was conducted on 22 patients who received tibial periosteal stretching for diabetic foot in our hospital from April 2020 to March 2022. The clinical and laboratory results were evaluated. [Results] All patients were operated on successfully, with no serious complications such as neurovascular injury, and were followed up for an average of (8.7±1.2) months. The patients got foot wound healing in an average of (31.5±2.2) days, with the limb preservation rate of 100%. Compared with those preoperatively, the VAS score [(5.3±0.8), (3.1±0.7), (2.9±0.7), P＜0.001], ankle brachial index [(0.6± 0.1), (0.8±0.3), (1.0±0.4), P＜0.001], the foot skin temperature [(25.9±2.4)℃, (27.7±3.1)℃, (29.0+4.0)℃, P＜0.001], percutaneous oxygen partial pressure [(24.7±4.2) mmHg, (36.2±3.8) mmHg, (45.7±5.3) mmHg, P＜0.001], SemmesWeinstein monofilament test [(4.8±0.9) g, (5.4±0.8) g, (7.5±0.8) g, P＜0.001] improved significantly 23 days and 93 days postoperatively. In terms of blood test, the levels of vascular endothelial growth factor, basic fibroblast growth factor, epidermal cell growth factor, and plateletderived growth factor increased significantly 10 days or 24 days after surgery compared with those preoperatively (P＜0.05). [Conclusion] Periosteal stretching does significantly promote microvascular regeneration and vascular reconstruction in chronic refractory wounds of diabetic foot, and promote wound healing of affected limb.

Abstract:[Objective] To compare the early results of general and local anesthesia for percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar osteoporotic fractures. [Methods] A retrospective study was conducted on 104 patients who received PKP for thoracolumbar osteoporotic fractures in our hospital from September 2022 to October 2023. According to preoperative doctor-patient communication, 51 patients had PKP performed under general anesthesia (GA), while other 53 patients were under local anesthesia (LA). The clinical and imaging data during hospitalization were compared between the two groups. [Results] The GA group proved significantly superior to the LA group in terms of operation time [(42.2±2.7 min) vs (53.6± 4.1) min, P＜0.001], fluoroscopy times [(25.7±6.3) vs (32.4±9.6), P＜0.001] and Kolcaba comfort score [(83.4 ± 8.6) vs (74.7 ± 8.1), P＜0.001], whereas the former resumed walking significantly later than the latter [(29.5±5.5) hours vs (26.6±3.4) hours, P=0.002]. There was no statistically significant difference in the incidence of early adverse reactions between the two groups (P＞0.05). Regarding imaging, the anterior vertebral height (AVH) and local kyphotic angle (LKA) were significantly improved postoperatively in both groups compared with those preoperatively (P＜0.05). At the discharge, the GA group was significantly superior to the LA group in terms of AVH [(23.5±1.3) mm vs (20.1±1.1) mm, P＜0.001] and LKA [(7.2±1.7)° vs (9.3±1.8)°, P＜0.001]. [Conclusion] Compared with under local anesthesia, the PKP under general anesthesia does indeed reduce the operation time and radiation exposure, reconstruct the vertebral body better with considerably better comfort level.

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