Abstract:[Objective] To compare the clinical outcomes of endoscopic transforaminal lumbar interbody fusion (E-TLIF) versus endoscopic interlaminal lumbar interbody fusion (E-ILIF) for degenerative lumbar spondylolisthesis. [Methods] A retrospective study was conducted on 32 patients who received endoscopic lumbar interbody fusion with cylindrical expandable fusion cage for degenerative lumbar spondylolisthesis in the Fourth Medical Center, General Hospital of PLA from August 2018 to April 2019. According to the indications, ETLIF was performed in 14 cases, while E-ILIF was used in the other18 cases. The documents regarding to perioperative period, follow-up and imaging were compared between the two groups. [Results] All patients in both groups had the operation finished smoothly without nerve root injury or dural tear. There were no significant differences between the two groups in terms of operation time [(121.8±45.1) min vs (129.7± 21.5), P=0.388], length of incision, [(5.8±0.2) cm vs (6.2±0.2) cm, P=0.070], postoperative walking time [(44.9±7.8) h vs (42.6±6.3) h, P 0.363] and hospitalization time [(10.4±2.8) d vs (11.0±2.3) d, P 0.538], and all of them in both groups got incisions healed in grade A. With time of follow-up period lasted for an average of (25.8±8.2) months, the VAS scores for lower back pain and leg pain, as well as ODI scores were significantly reduced in both groups (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Radiographically, the intervertebral space height and lumbar lordosis angle (L1~L5 Cobb Angle) significantly increased in both groups after surgery compared with those preoperatively (P＜0.05), however, there were no statistically significant differences in the abovesaid imaging parameters between the two groups at corresponding time points (P＞0.05). Mannion fusion grade was significantly im-proved in both groups at the last follow-up compared to 6 months after surgery (P＜0.05), whereas there were no statistically significant differences in interbody fusion and fusion cage location between the two groups (P＞0.05). [Conclusion] There is no significant difference in clinical and imaging consequences between E-TLIF and E-ILIF. The cylindrical expandable fusion cage can safely apply in the two types of endoscopic lumbar fusion

Abstract: [Objective] To explore the factors related to poor incision healing after spinal tuberculosis surgery in Xizang region. [Meth ods] From January 2017 to December 2023, 104 patients who received surgical treatment for spinal tuberculosis were included in this study, and the incidence of postoperative poor incision healing was observed. Univariate comparison and multiple logistic regression analysis were used to explore the related factors of poor wound healing. [Results] Among 104 patients who underwent surgical treatment for spinal tuberculosis, 34 patients showed poor wound healing after surgery, accounted for 32.7% (34/104). The poor incision healing group proved significantly greater than the normal healing group in terms of the proportion of irregular anti-tuberculosis treatment [irregular/normal, (21/3) vs (45/25), P＜0.001], the proportion of preoperative hypoproteinemia [yes/no, (26/8) vs (31/29), P=0.002], and the proportion of anemia [yes/no, (22/12) vs (26/44), P=0.008], white blood cells [(8.5±2.5) ×109 /L vs (5.8±2.1) ×109 /L, P＜0.001], CRP [(60.6±39.9) mg/L vs (29.1±29.4) mg/L, P＜0.001], ESR [(39.9±20.3) mm/h vs (22.4±12.0) mm/h, P＜0.001] and the ratio of anterior surgical approach [(anterior/ posterior, (19/15) vs (22/48), P=0.031]. As results of multi-factor logistic regression analysis, the hypoalbuminemia (OR=7.658, P＜0.05), irregular anti-tuberculosis therapy (OR=4.736, P＜0.05), increased white blood cell count (OR=1.560, P＜0.05), accelerated ESR (OR=1.149, P＜0.05), and high CRP level (OR=1.019, P＜0.05) were the independent risk factor for poor incision healing after spinal tuberculosis surgery. [Conclusion] Preoperative irregular anti-tuberculosis therapy, hypoalbuminemia, increased white blood cell count, accelerated erythrocyte sedimentation rate and high C-reactive protein level are independent risk factors for poor wound healing after surgery for tuberculosis.

Abstract:[Objective] To compare the clinical consequence of oblique lateral lumbar interbody fusion (OLIF) versus posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar scoliosis (DLS), and provides evidence-based evidence for clinical practice. [Methods] The literatures to compare the OLIF versus PLIF/TLIF in the treatment of DLS were searched in PubMed, Embase, Cochrane Library, Web of Science, CNKI and Wanfang Medical database from the establishment of the database to February 2025. A meta-analysis was performed using RevMan 5.4 software. [Results] Eight papers were included in this research, all in type of retrospective cohort study, involving a total of 615 patients, including 306 patients in the OLIF group and 309 patients in the PLIF/TLIF group. As results of the meta-analysis, the OLIF group had significantly less intraoperative blood loss (MD=-263.49, 95%CI: -322.04~-204.94, P＜0.001) and significantly shorter fixed segments (MD=-3.20, 95%CI: -3.83~-2.57, P＜0.001), as well as significantly less main curvature Cobb angle (MD=-3.75, 95%CI: -4.60~-2.90, P＜0.001), significantly greater lumbar lordosis (LL) (MD= 4.65, 95%CI: 1.74~7.57, P=0.002) and significantly less pelvic incidence (PI) in the medium-term follow-up (MD=-5.72, 95%CI: 8.96~ 2.49, P＜0.001) than the PLIF/TLIF group. However, there were no significant differences between the OLIF group and PLIF/TLIF group in terms of operative time and perioperative complications, as well as back pain VAS score, ODI score and sagittal vertical axis (SVA) in the medium-term follow-up (P＞0.05). [Conclusion] Compared with PLIF/TLIF, OLIF has less intraoperative blood loss, shorter fixed segment, and smaller main curvature Cobb angle, larger LL and smaller PI-LL in medium-term follow-up. There are no significant differences between the two groups in operation time, perioperative complications, back pain, ODI score and SVA in medium-term follow-up. OLIF dem-onstrates a good safety and clinical efficacy for DLS in medium-term follow-up.

Abstract:Unilateral biportal endoscopy (UBE) technology is an emerging minimally invasive surgery for spinal diseases. Compared with other endoscopic surgeries, UBE technology has the advantages of a large field of view, a large instrument operation angle, and the same operating habits as traditional open surgery in the treatment of spinal diseases. At present, UBE technology is relatively mature, the number of surgeries is gradually increasing, and the therapeutic effect is generally satisfactory. However, postoperative complications such as dural sac rupture, epidural hematoma, and nerve root injury cannot be ignored. The average incidence of complications in UBE surgery reported in the literature is 6.7%. The most common complication is dural rupture with an average incidence of 4.1%, and epidural hematoma, with an incidence of about 8.4%. The incidence of incomplete postoperative decompression and nerve root injury is relatively low. This article will discuss the related complications of UBE technology in lumbar spine surgery and provide a review of the current research status.

Abstract:Low back pain is a widespread and expensive disease worldwide, and intervertebral disc degeneration (IDD) is one of its main causes. The specific mechanism of IDD remains unknown clearly, although many factors can induce or accelerate its progression, and the intestinal microorganisms and their metabolites may be one of them. At present, there are three main mechanisms by which intestinal microorganisms plays roles on IDD, including translocation of bacteria across the intestinal epithelial barrier into IVD, regulation of mucosal and systemic immune systems, and regulation of nutrient absorption and metabolite production of the intestinal epithelium and its spread to the IVD. This article reviews the mechanisms that intestinal microorganisms affect IDD and related treatment methods, providing a reference for further research on the correlation between intestinal microorganisms with their metabolites and IDD, as well as related treatments.

Abstract:Intervertebral disc degeneration (IVDD) is one of the most important causes of lumbago and leg pain, which is the result of multiple factors such as cartilaginous end-plate degeneration, intervertebral disc environment imbalance, inflammatory reaction and nucleus pulposus cell apoptosis. SIRT6 in the silent information regulator (SIRT) family has been found to be involved in delaying cell aging through DNA repair, regulating autophagy, improving inflammation and other pathways. Current studies have shown that SIRT6 may play an important role in delaying IVDD by alleviating inflammation, moderating cell senescence and inhibiting apoptosis, thereby improving the degenerative state of the intervertebral disc. However, at present, there are few relevant literatures, so this paper reviews the mechanism of SIRT6 regulation of IVDD, aiming to provide new information for the basic and clinical research of IVDD.

Abstract:Low back pain (LBP) is a common symptom of degenerative diseases of the musculoskeletal system, and has become a serious medical and social problem worldwide, resulting in poor quality of life for patients and consuming a large amount of medical resources. Intervertebral disc degeneration (IVDD) caused LBP accounted for about 40%, while the specific pathogenesis of IVDD is not fully understood at present. Insulin-like growth factor 1 (IGF-1) is a key growth-promoting peptide, which plays a key role in the proliferation, differentiation, apoptosis and regulation of the extracellular matrix (ECM) of chondrocytes. Previous studies have shown that IGF-1 can regulate multiple target genes and activate different pathways during IVDD, and participate in the regulation of ECM degradation, apoptosis and senescence. This paper discusses the potential relationship between IGF-1 and IVDD development, and IGF-1 may be a promising new therapeutic target for the clinical management of IVDD.

Abstract:Low back pain caused by intervertebral disc degeneration (IDD) has caused great trouble to people's health, and extensive concern in the whole society. At present, the main treatment methods for the pain caused by IDD are still only surgical treatment and conservative treatment, which can not repair IDD in a real sense. Nanomedicine with particle size between 1~100 nm, which has emerged in recent years, has many unique advantages in repairing IDD, and can accurately reverse IDD through various mechanisms, bringing good news to patients. This paper focuses on the successful nanomedicine for repairing IDD developed by major laboratories in recent years, expounds its advantages, innovation and feasibility, and analyzes the current limitations of nanomedicine and its carriers, in order to provide a reference for the clinical transformation of nanomedicine in the future.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of modified microscopy-channel assisted discectomy of extreme lateral lumbar disc herniation. [Methods] A patient underwent the abovesaid operation. The patient was placed in a prone position with a para-midline approach made. A minimally invasive channel was placed on the shoulder of the superior facet of the lower vertebrae to exposure the upper lateral articular process, part of the lateral isthmus of the upper vertebrae, and the inter-transverse ligament. With the aid of microscope, the upper lateral margin of the superior articular process was removed, while the isthmus remained, to expose the external outlet of the foramen. Turning the channel forward the foramen and the internal foramen region, the herniated disc was removed and the nerve root was released. [Results] The operation was conducted successfully, with operation time of 78 min and intraoperative blood loss of 50 mL. The pain of the affected limb disappeared after the operation, while the straight leg raise test turned to be negative, and the modified MacNab grade was marked as best. The visual analogue scale (VAS) decreased from 9 before surgery to 3 2 days after operation and 1 a month after surgery. Postoperative CT showed that the articular surface of the facet and the isthmus of the lamina were intact. [Conclusion] This modified microscope -channel assisted discectomy for extreme lateral lumbar disc herniation has the advantages of minimally invasive surgery, direct and precise nerve decompression, and few impact on the stability of the lumbar spine.

Abstract:[Objective] To compare the spinopelvic sagittal parameters among different lumbar spondylolisthesis states. [Methods] A retrospective research was done on lumbar spondylolisthesis 104 patients and 40 normal subjects from January 2020 to June 2024. According to the imaging findings, 32 patients had two consecutive segments of spondylolisthesis (the double group), 72 had single segment spondylolisthesis (the single group), and 40 had no spondylolisthesis (the normal group). The clinical and imaging parameters of the three groups were compared. [Results] The double group proved significantly higher low back pain VAS score [(5.2±0.8) vs (4.8±0.7), P=0.012]，leg pain VAS score [(5.5±1.0) vs (5.1±0.9), P=0.046]，ODI index [(48.5±6.6)% vs (44.2±5.4)%, P=0.001] than the single group. There was no significant difference in age, gender and BMI among the three groups (P＞0.05). The double group, single group and normal group had pelvic incidence (PI) [(65.2±6.5)° vs (53.7±5.3)° vs (44.9±4.8)°, P＜0.001], pelvic tilt (PT) [(26.6±3.8)° vs (18.6±3.0)° vs (10.6±2.2)°, P＜0.001], sagittal vertical axis (SVA) [(6.7±1.5) cm vs (3.4±0.7) cm vs (0.9±0.2) cm, P＜0.001], sacral slope (SS) [(38.6±4.7)° vs (35.1±3.6)° vs (34.3± 3.2)°, P＜0.001] ranked up-down significantly, whereas thoracic kyphosis (TK) [(29.7±6.8)° vs (31.5±7.2)° vs (34.0±8.0)°, P＜0.001] and lumbar lordosis (LL)[(44.8±4.6)° vs (48.3±5.5)° vs (49.7±6.5)°, P＜0.001] down-up significantly. The VAS score of low back pain was positively correlated with PI, PT, SVA and SS (P＜0.05), whereas negatively correlated with TK and LL (P＜0.05). [Conclusion] The two consecutive segments lumbar spondylolisthesis presents more serious clinical symptoms, with more significant spinopelvic sagittal parameters changes, including incresed PI, PT, SVA and SS, while decreased TK and LL.

Abstract:[Objective] To compare the analgesic outcomes of lumbar plexus block (LPB) versus improved high fascia iliaca compartment block (IHFICB) in total hip arthroplasty (THA). [Methods] From March 2022 to October 2023, 210 patients who were undergoing THA for end-stage hip diseases under lumbar anesthesia were enrolled into this study and divided into two groups by coin toss method. Of them, 102 patients were treated with LPB, while other 108 patients were with IHFICB. The clinical and analgesic data of the two groups were compared. [Results] Although the LPB group consumed significantly longer time in block operation time than that the IHFICB group [(14.5±5.5) min vs (8.4±3.8) min], the former got block effect significantly earlier than the latter [(9.2±2.4) min vs (12.6±3.0) min, P＜0.001]. There were no significant differences between the two groups in terms of operation time, intraoperative blood loss, hospital stay, bed rest time, incidence of total adverse reactions, postoperative time to regain full weight walking, and postoperative Harris score (P＞0.05). As for analgesia, there were no significant differences in the time of first use of analgesia pump, the number of analgesia pump use, the number of relief analgesia, and postoperative VAS scores between the two groups (P＞0.05). [Conclusion] Both LPB and IHFICB achieve good and satisfactory analgesic consequence in THA. The LPB gives faster analgesic effect, while the IHFICB has shorter operation time.

Abstract:[Objective] To evaluate the effects of correction of earlyonset thoracic scoliosis with growth rod on lung development. [Methods] A retrospective study was done on 30 patients who had early-onset thoracic scoliosis treated by growth rod technique. The clinical and imaging data, as well as changes in lung development parameter were evaluated. [Results] All the patients successfully completed the first growth rod implantation and each extension operation with a total of 121 times of operation, and followed up for a mean of (38.6± 7.3) months. The patients were significantly improved over time in terms of standing height [(115.6±13.1) cm, (120±12.9) cm, (123.9±14.3) cm, P=0.021], sitting height [(81.5±12.9) cm, (84.3±11.9) cm, (88.7±12.1) cm, P= 0.009], main curve Cobb angle [65.6±22.8)°, (45.6±21.6°, (40.6±22.7)°, P=0.018], thoracic kyphosis (TK) [(48.5±21.9)°, (28.0±13.5)°, (26.6±12.2)°, P=0.027], as well as lung development parameter, including T1~12 height, maximum thoracic width, anteroposterior thoracic diameter, sagittal longitudinal diameter and Campbell's space available for lung ratio (SAL) (P＜0.05). The pulmonary function indexes were also significantly improved (P＜0.05), despite of the fact that the residual volume (RV) and residual ratio (RV/TLC) remained unchanged significantly (P＞0.05). [Conclusion] Correction of early-onset thoracic scoliosis with growth rod can not only correct the thoracic spine deformity, raise the spine height, increase the width, height and anteroposterior diameter of the thoracic cavity, but also expand the thoracic volume, correct the asymmetry of the left and right thoracic cavity, and improve the pulmonary function.

Abstract:[Objective] To compare the clinical efficacy of radial extracorporeal shock wave therapy (ESWT) combined with non-steroidal patch versus local glucocorticoid injections (LGI) in the treatment of frozen shoulder. [Methods] A retrospective study was conducted on 56 patients had frozen shoulder treated in outpatient department of our hospital from April 2022 to April 2023. According to doctor-patient communication before treatment, 28 patients received ESWT, while other 28 patients underwent LGI. The clinical data of the two groups were compared. [Results] All patients in both groups received the corresponding therapy successfully without complications, such as drug allergy, neurovascular injury and infection. Compared with those before treatment, the VAS score was significantly decreased (P＜ 0.05), while ASES score, Constant score, UCLA score and shoulder abduction and elevation range of motion (ROM) were significantly increased in both groups at the latest follow-up (P＜0.05). Before treatment, there was no statistical significance in the above items between the two groups (P＞0.05). At the last follow-up, there were no significant differences in VAS score, Constant score and abduction ROM between the two groups (P＞0.05), whereas the ESWT group proved significantly superior to the LGI group in terms of ASES score [(89.0±8.7) vs (76.5±10.7), P＜0.001], UCLA score [(30.9±3.3) vs (27.9±4.5), P=0.006]. [Conclusion] The radial extracorporeal shock wave therapy combined with non-steroidal patch does achieve a good clinical consequence for frozen shoulder.

Abstract: [Objective] To evaluate the clinical outcome of the nursing intervention based on information-motivation-behavior (IMB) model for posterior lumbar interbody fusion (PLIF). [Methods] A total of 100 patients who were undergoing PLIF for lumbar degenerative diseases in our hospital from May to October 2023 were enrolled into this study and divided into 2 groups by random number table method. Of them, 50 patients received IMB care, while other 50 patient underwent conventional care. The clinical data of the two groups were compared. [Results] There were no significant differences in operation time, intraoperative blood loss, postoperative drainage and total complications between the two groups (P＞0.05). However, the IMB group proved significantly superior to the conventional group in terms of postoperative bed rest time [(3.4±0.4) days vs (4.2±0.5) days,P＜0.001] and hospital stay [(11.0±2.3) days vs (12.1±3.5) days, P=0.049], as well as VAS score [(4.1±0.7) vs (4.5±0.7), P=0.010; (1.1±0.7) vs (1.5±0.9), P=0.032], ODI score [(51.4±1.9) vs (55.1±1.7), P＜0.001; (21.3±2.1) vs (23.5±2.1), P＜0.001], compliance score [(54.6±1.7) vs (49.7±3.2), P＜0.001; (57.0±2.4) vs (53.9±1.9), P＜0.001], HADS-D score [(8.7±1.5) vs (9.4±1.9), P=0.046; (5.9±1.6) vs (6.7±1.5), P=0.020] at discharge and 1 month after surgery, additionally, HADS-A score [(8.2±1.8) vs (9.5±1.7), P＜0.001] at discharge. [Conclusion] IMB based nursing intervention can reduce postoperative pain of PLIF, promote the recovery of lumbar function, improve their exercise compliance, reduce the occurrence of anxiety and depression, and shorten the hospital stay.

Abstract: