Abstract:The exercise rehabilitation for lumbar intervertebral disc protrusion needs to formulate individualized plans according to the disease stage. Based on expert consensus, this article systematically summarizes the recommended opinions for exercise rehabilitation of lumbar intervertebral disc protrusion. During the acute stage, it is recommended to intervene in exercise rehabilitation when the pain no longer aggravated. The main focus should be on light to moderate-intensity exercises that do not aggravate the symptoms, such as short-distance activities with lumbar braces worn. When lying in bed, one should choose a medium-hardness mattress and adopt a position that can reduce the load on the lumbar vertebrae. During the recovery period, the focus should be on strengthening deep core muscle groups, such as the psoas major and multifidus. The training should gradually transition from static and low-intensity to dynamic resistance training, and flexibility training can be combined at the same time. However, vigorous exercise, bending, spinning and vertical vibration activities should be avoided. At home, advanced core training, water exercises or Tai Chi can be chosen. Rehabilitation was carried out in stages during the perioperative period. Preoperative pre-rehabilitation was combined with postoperative systematic assessment to formulate an exercise plan. The exercise intensity was gradually increased within 6 weeks after the operation, while emphasizing early out-of-bed activities and core stability training. During the rehabilitation process, attention should be paid to pain management, psychological intervention and the rational use of protective gear, additionally, the importance of multidisciplinary collaboration and personalized plans should be emphasized. This consensus provides evidence-based basis and clinical practice guidance for exercise rehabilitation of lumbar intervertebral disc protrusion, aiming to improve the therapeutic effect and reduce the risk of recurrence.

Abstract:[Objective] To compare the clinical efficacy of the Wiltse approach versus the posterior midline approach in Dynesys dynamic stabilization system used for lumbar degenerative diseases. [Methods] A retrospective study was conducted on patients who received fixation with Dynesys dynamic stabilization system for lumbar degenerative diseases in our hospital from September 2017 to June 2022. Based on the preoperative doctor-patients discussion, 61 patients had lumbar fixation through the Wiltse approach (WA), while the other 29 patients were through the posterior midline approach (PMA). The documents regarding perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had corresponding surgical procedures performed successfully without severe surgical complications. There were no significant differences in incision length or operative time between the two groups (P＞ 0.05). However, the WA group demonstrated significantly less intraoperative blood loss [(114.0±51.6) mL vs (149.3±54.6) mL, P＜0.001] and postoperative drainage volume [(64.4±16.1) mL vs (173.1±26.8) mL, P＜0.001] compared to PMA group. The postoperative visual analog scale (VAS) scores for back and leg pain, as well as Oswestry Disability Index (ODI) scores, showed significant improvement at all time points compared to those preoperatively (P＜0.05). Notably, the WA group reported significantly superior to the PMA group in terms of VAS scores [(2.6±1.5) vs (4.0±1.9), P＜0.001; (1.9±1.3) vs (3.0±1.5), P＜0.001] and JOA score [(16.7±1.1) vs (15.5±1.2), P＜0.001; (21.0±1.1) vs (18.5±0.7), P＜0.001] 1 week and 1 month postoperatively. With respect of imaging, WA group proved significantly greater horizontal screw placement angle than the PMA group at L4 [(27.1±4.1)° vs (22.6±4.2)°, P＜0.001], L5 [(26.4±4.1)° vs (21.5±4.5)°, P＜0.001] and S1 [(20.4±3.4)° vs (18.1±3.8)°, P＜0.001]. However, there was no statistical significance in the accuracy of screw placement between the two groups (P＞ 0.05). The operated segment range of motion (ROM) and vertebral canal occupied rate were significantly decreased in both groups 3 months after surgery and at the last follow-up compared with those preoperatively (P＜0.05), regardless of the intervertebral height and lumbar lordotic angle remained unchanged (P＞0.05). At any corresponding time points, there were no significant differences in the above image items between the two groups (P＞0.05). [Conclusion] Dynesys stabilization system used for fixation of lumbar degenerative diseases through the Wiltse approach does achieve similar clinical consequence to that through the traditional posterior median approach. However, the Wiltse approach has less muscle damage, less bleeding, more ideal screw placement, less postoperative drainage and less pain, which is more in line with the concept of minimally invasive spinal surgery.

Abstract:[Objective] To evaluate and compare the clinical efficacy of two types of internal fixation methods in the treatment of thora-columbar spinal fractures. [Methods] From June 2019 to June 2022, 116 patients with thoracolumbar spinal fractures treated in our department were included in this study. According to patient preference, 58 cases underwent Wiltse paraspinal muscle approach pedicle screw fixation (Wiltse approach pedicle screw fixation, WAPSI), and 58 cases underwent percutaneous pedicle screw fixation (percutaneous pedicle screw fixation, PPSF). The perioperative period, follow-up, and imaging data of the two groups were compared. [Results] The WAPSF group proved significantly superior to the PPSF group in terms of operation time [(88.0±15.3) min vs (112.2±10.3) min, P＜0.001], intraoperative fluoroscopy times [(3.6±0.6) vs (7.1±1.4), P＜0.001] and hospitalization cost [(3.6±0.5) 10 kyuan vs (5.0±0.7) 10 kyuan, P＜0.001], whereas the former was significantly inferior to the latter regarding incision length [(8.0±1.4) cm vs (2.0±0.5) cm, P＜0.001], intraoperative blood loss [(162.5±20.0) mL vs (60.7±8.4) mL, P＜0.001], postoperative drainage [(164.0±20.1) mL vs (85.4±10.3) mL, P＜0.001] and hospital stay [(14.3±3.2) days vs (12.4 ± 2.2) days, P＜0.001]. With time of follow-up lasted for more than 12 months, the pain VAS and ODI scores significantly decreased in both groups (P＜0.05), and the WAPSF had significantly higher VAS score than the PPSF group 7 days and 1 month after surgery (P＜0.05). As for imaging, the local kyphotic Cobb angle significantly decreased (P＜0.05), while the ratio of anterior height of injured vertebra significantly increased in both group postoperatively compared with those preoperatively (P＜0.05). However, there were no significant differences in the local kyphotic Cobb angle and the ratio of anterior vertebral height between the two groups at any time points accordingly (P＞0.05). [Conclusion] The clinical outcomes of WAPSF and PPSF for the treatment of thoracolumbar fractures are similar. Compared with each other, WAPSF has a shorter operation time, fewer fluoroscopy counts, and lower costs, while PPSF has smaller incisions, less blood loss, and milder early postoperative pain.

Abstract:[Objective] To compare the clinical consequence of large channel endoscopic keyhole technique, (LCEKT) versus anterior cervical discectomy and fusion (ACDF) for single-level cervical spondylotic radiculopathy (CSR). [Methods] A retrospective study was performed on 46 patients who underwent surgical treatment for CSR in our hospital from December 2020 to September 2023. According to preoperative doctor-patient communication, 21 patients received LCEKT, while other 25 patients underwent ACDF. The documents regarding perioperative period, follow-up and images were compared between the two groups. [Results] The operation was successfully completed in both groups. The LCEKT group was proved significantly superior to the ACDF group in terms of operative time [(78.4±10.1) min vs (93.4± 9.6) min, P＜0.001], intraoperative blood loss [(13.2±5.2) mL vs (52.4±7.6) mL, P＜0.001], incision length [(0.8±0.1) cm vs (5.1±0.2) cm, P＜ 0.001], intraoperative fluoroscopy times [(4.2±0.5) vs (6.7±1.2), P＜0.001] ambulation time [(15.7±6.5) days vs (34.6±3.7) days, P＜0.001] and hospital stay [(5.6±1.0) days vs (9.3±1.3) days, P＜0.001]. With time of the follow-up period lasted for (13.6±0.8) months in a mean, the neck pain VAS, upper limb pain VAS, NDI and JOA scores were significantly improved in both groups (P＜0.05). Except that the neck VAS score in the LCEKT group [(2.3±0.6) vs (3.5±0.7), P＜0.001] was significantly better than that in the ACDF group 1 week after surgery, there was no statistical significance in the abovesaid indexes between the two groups at any time points accordingly (P＞0.05). Regarding imaging, the postoperative cervical lordosis angle and vertebral canal occupancy rate were significantly improved in both groups compared with those preoperative (P＜0.05). The cervical range of motion (ROM) and intervertebral height remained unchanged in the LCEKT group (P＞0.05), whereas the intervertebral height in ACDF group was significantly increased postoperatively compared with that preoperatively (P＜0.05). Although there was no statistical significance in the above imaging parameters between the two groups before surgery (P＞0.05), the LCEKT group had significantly less cervical lordosis angle [(12.6±2.3)° vs (15.7±2.5)°, P＜0.001] and intervertebral height [(5.4±0.5) mm vs (7.5± 0.7) mm, P＜0.001], whereas significantly greater cervical ROM [(44.0±5.7)° vs (38.4±5.6)°, P=0.002] than the ACDF group at the latest follow-up. [Conclusion] Both surgical techniques do achieve good clinical results in the treatment of CSR. By comparison, the LCEKT has the advantages of less trauma, less bleeding, faster recovery, and preserving cervical segmental motion over the ACDF. In addition, the large-channel endoscopic system provides the surgeon with a broader view field and more flexible operating space to improve operative efficiency and reduce surgical risk.

Abstract: [Objective] To compare the clinical efficacy of posterior lumbar interbody fusion (PLIF) with porous titanium cage produced by 3D printing versus poly-ether-ether-ketone (PEEK) cage for the low-extent spondylolisthesis. [Methods] From December 2020 to May 2023, a total of 62 patients who were undergoing PLIF for gradeⅠorⅡdegenerative or isthmic lumbar spondylolisthesis were included in this study, and divided into two groups by random number table method. Of them, 32 patients had PLIF performed with porous titanium cage (titanium group), while the other 32 patients were with PEEK cage (PEEK group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had PLIF performed successfully, without statistically significant differences in operation time, total incision length, intraoperative blood loss, intraoperative fluoroscopy times, ambulation time, incision healing grade, hospital stay and complication rate between the two groups (P＞0.05). The average followup time was of (14.7±3.3) months, and there was no a statistically significant difference between the two groups in the time to return to full weightbearing activities (P＞0.05). Compared with those preoperatively, lower back pain VAS, leg pain VAS, ODI and QBPDS scores were significantly reduced at 3 months after surgery and the last follow-up in both groups (P＜0.05). At any corresponding time points, there were no statistically significant differences in the above indexes between the two groups (P＞0.05). As for imaging, compared with those preoperatively, the degree of spondylolisthesis, slippage percentage, lumbar lordotic angle were significantly improved in both groups at each time point after surgery (P＜0.05). Compared with that 3 months postoperatively, the vertebral space height loss rate was significantly increased 6 months after surgery and at the last follow-up (P＜0.05). The titanium group proved significantly less vertebral space height loss rate than the PEEK group [(4.4±2.4)% vs (7.6±3.4)%, P＜0.001] 3 months, [(6.0±2.3)% vs (10.4±2.9)%, P＜0.001] 6 months, and [(7.1±3.1)% vs (12.4±3.6)%, P＜0.001] 12 months after operation, despite of the fact that no statistically significant differences were noted in terms of the degree of spondylolisthesis, slippage percentage, lumbar lordotic angle and interbody fusion rate between the two groups (P＞0.05). [Conclusion] PLIFs with both porous titanium cage and PEEK cage do effectively treat lowgrade lumbar spondylolisthesis. In contrast, the porous titanium cages significantly reduced postoperative vertebral space subsidence.

Abstract:[Objective] To investigate the clinical efficacy of 3D CT reconstruction for simulation before percutaneous pedicle screw (PPS) fixation in the treatment of thoracolumbar fractures. [Methods] A retrospective study was conducted on 85 patients who had thoraco-lumbar fractures fixed with PPS in our hospital from June 2021 to June 2023. According to the preoperative doctor-patient communication, 40 patients received CT 3D reconstruction for simulation before PPS (planning group), while other 45 patients had routine PPS performed without preoperative 3D reconstruction for simulation (routine group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both group were successfully operated on. The planning group proved significantly superior to the routine group in terms of operation time [(84.5±16.4) min vs (98.2±20.3) min, P＜0.001], intraoperative X-ray exposure times [(6.1±2.3) times vs (10.4±3.0) times, P＜0.001], intraoperative blood loss [(48.3±5.2) mL vs (65.3±8.7) mL, P＜0.001], postoperative ambulation time [(26.4± 2.8) days vs (28.0±3.4) days, P=0.021], the screw placement position [excellent/good/fair/poor, (200/20/10/0) vs (186/30/29/0), P＜0.001] and the success rate of first screw placement (95.0% vs 80.0%, P=0.040). The average follow-up time was (15.5±2.0) months, and there was no significant difference in time to resume full weight-bearing activity between the two groups (P＞0.05). The VAS and ODI scores were significantly decreased in both groups over time (P＜0.05). The planning group was significantly better than the routine group regarding VAS score 1 week after surgery [(4.0±0.6) vs (4.3±0.7), P=0.038] and ODI score 3 months postoperatively [(22.4±6.0) vs (25.0±5.7), P=0.044]. With respect of imaging, the anterior and posterior heights of fractured vertebrae were significantly increased (P＜0.05), while the local kyphosis was significantly decreased in both group postoperatively compared with those preoperatively (P＜0.05), which were not statistically significant between the two groups at any corresponding time points (P＞0.05). [Conclusion] CT 3D reconstruction for simulation before PPS fixation of thoracolumbar fractures with advantages of shortening the operation time, reducing the number of X-ray exposure, and achieving better screw placement accuracy, is conducive to the early functional recovery of the patients.

Abstract:Spinal vascular malformation (SVM) is a heterogeneous type of congenital spinal vascular dysplasia that can lead to acute, subacute, or chronic spinal cord dysfunction. In clinical practice, MRI is the primary diagnosis of SVM in the early stage, while angiography is the gold standard for definitive diagnosis. The main treatment options include surgery and intravascular therapy, but the early diagnosis and treatment of the disease are still insufficient, resulting in aggravated disease changes and even paraplegia. This paper reports a case of spinal vascular malformation treated by surgery, and reviews the literature on the pathogenesis, classification, clinical manifestations, diagnosis and treatment of SVM, providing suggestions for the diagnosis and treatment of this disease.

Abstract:Intervertebral disc degeneration (IVDD) is the basic pathological process of many spinal degenerative diseases, and its clinical manifestations include spinal stenosis, lumbago and leg pain, etc. With in-depth study of macrophages in intervertebral disc degeneration, macrophages have been proved to be the key factor in the development of IVDD. The latest research shows that non-coding RNA, inflammatory factors, chemokines, new molecular materials, traditional Chinese medicine and other factors can induce the polarization of macrophage M1 or M2, and have a series of effects on nucleus pulposus cells, extracellular matrix, endplate cells and so on, thus aggravating or alleviating IVDD. This paper aims to introduce the factors that regulate macrophage recruitment and polarization in the process of intervertebral disc degeneration, and summarize the potential cellular and molecular mechanisms that regulate macrophage recruitment and polarization in intervertebral disc degeneration, to provide a reference for the origin, progress and potential treatment strategies of intervertebral disc degeneration.

Abstract:With the increasing degree of aging of the population, the incidence of osteoporotic vertebral compression fracture (OVCF) in the elderly is becoming higher and higher. The acceptance and popularity of vertebral augmentation procedure, such as percutaneous ver-tebroplasty, kyphoplasty and cement-reinforced pedicle screw internal fixation, are gradually increasing, whereas the occurrence and reports of related complications are also increasing. Bone cement pulmonary embolism, one of the most serious potentially fatal complications, has become a key factor in evaluating surgical quality, and clinicians are paying increasing attention to it. In order to further optimize the treatment plan, improve the perioperative safety and reduce the medical cost, the related research of bone cement pulmonary embolism after vertebral augmentation has become a hot spot again. This article reviews the clinical manifestations, diagnosis, risk factors, treatment and prevention of bone cement pulmonary embolism after vertebral augmentation.

Abstract:[Objective] To explore the causal relationship between mental disorders and cervical spondylosis by using Mendelian randomization analysis, and further explore the mediation factors, to provide theoretical basis for the prevention and treatment of cervical spondylosis. [Methods] Data on cervical spondylosis, mental disorders (depression, anxiety and schizophrenia), and living habits (smoking, insomnia, drinking, exercise, and time spent watching TV) were collected from the aggregated data of GWAS. Inverse variance weighted (IVW) method was adopted as the main method, the other four methods were adopted as the complementary methods to evaluate the causal relationship between mental disorders and cervical spondylosis. IVW was used to analyze the causal relationship between the three mental disorders and cervical spondylosis after adjustment. According to the steps of exposure to mediation and mediation to outcome, the qualified mediation factors in living habits were screened out, and the P-value of mediation effect was calculated by coefficient product test. The confidence interval was estimated by Delta method, and the proportion mediated was calculated. [Results] The univariable analysis indicated that depression was a risk factor for cervical spondylosis (OR=1.398, 95% CI: 1.085~1.803, P=0.010), while the multivariable analysis showed that depression still had positive causal relationship with cervical spondylosis after adjustment for anxiety and schizophrenia (OR= 1.343, 95%CI: 1.06~1.70, P=0.013). The mediation MR analysis showed that the causal relationship between depression and cervical spondylosis was partly mediated by smoking and insomnia, with the proportion mediated of 16.0% and 41.7% respectively. [Conclusion] Our study shows that there is a positive causal relationship between depression and cervical spondylosis, which is partly mediated by smoking and insomnia.

Abstract:[Objective] To investigate the short-term clinical efficacy of unilateral biportal endoscopic posterior cervical foraminotomy (UBEPCF) combined with discectomy in the treatment of cervical spondylotic radiculopathy (CSR). [Methods] A retrospective research was done on 32 patients who received UBE-PCF combined discectomy for CSR from January 2022 to April 2023. Clinical efficacy, imaging data and related complications were evaluated. [Results] All the patients had operation performed smoothly with the average operation time of (96.7±14.6) min, the average intraoperative blood loss of (9.8±2.7) mL. However, there were 2 cases of rupture of dural sac, 2 cases of mild nerve root injury, and no spinal cord injury. All the 32 patients were followed up for an average of (13.9±2.3) months. With time elapsed preoperatively, 3 months after surgery and the last follow-up, the neck pain VAS score [(6.5±1.2), (2.8±1.1), (1.3±0.6), P＜0.001], arm pain VAS score [(6.7±1.4), (2.9±1.1), (1.6±0.6), P＜0.001], NDI score [(30.2±4.9), (10.6±2.6), (6.2±2.2), P＜0.001] and JOA score [(14.3±0.8), (15.4± 0.8), (16.2±0.7), P＜0.001] were significantly improved, despite of the fact that UBE revision was performed in 2 patients due to inadequate decompression. As for imaging, the anterior and posterior heights of the affected intervertebral space were significantly decreased 3 months after surgery and at the last follow-up compared with the preoperative ones (P＜0.05), whereas the sagittal diameter of intervertebral foramen and cervical lordosis remained unchanged significantly (P＞0.05). [Conclusion] UBE-PCF combined discectomy in the treatment of CSR has advantages of less trauma, quick recovery and definite good short-term consequence, and is a good alternative to the traditional PCF for CSR.

Abstract:[Objective] To compare the clinical efficacy of unilateral biportal endoscopy (UBE) versus bilateral biportal endoscopy (BBE) for gradeⅠ/Ⅱ L5S1 spondylolisthesis. [Methods] A retrospective study was done on 21 patients who had gradeⅠ/Ⅱ L5S1 spondylolisthesis treated with endoscopic lumbar interbody fusion from August 2021 to January 2024. Of them, 10 patients suffered from grade I spondylolisthesis with unilateral lower limb symptoms received UBE, while other 4 patients suffered from grade I spondylolisthesis with bilateral lower limb symptoms, and 7 patients with gradeⅡspondylolisthesis underwent BBE. The clinical and imaging data of the two groups were compared. [Results] All patients in both groups had lumbar interbody fusion performed successfully. The UBE group consumed significantly longer operation time than the BBE group [(178.5±22.8) min vs (139.1±17.1) min, P＜0.001]. However, there were no significant differences between the two groups in intraoperative fluoroscopy times, bed rest time and hospital stay between the two groups (P＞0.05). All patients in both group were followed up for an average of (12.3±3.0) months. Compared with those preoperatively the VAS scores for low back pain and leg pain, as well as ODI score in both groups were significantly decreased 6 months after surgery (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Regarding to imaging, the vertebral space height, vertebral canal area and slippage ratio were significantly improved in both groups 6 months after surgery compared with those preoperatively (P＜0.05). There was no statistical significance in the intervertebral space height and vertebral canal area between the two groups (P＞0.05), but the slippage ratio in UBE group was significantly lower than that of BBE group before surgery [(16.0±6.4)% vs (22.7±9.0)%, P=0.041]. At the last follow-up, the UBE group was significantly inferior to the BBE group in term of slippage reduction rate [(53.5±18.2)% vs (80.8±17.7)%, P=0.004], despite of the fact that no significant differences were noted in intervertebral space height and vertebral canal area between the two groups (P＞0.05). [Conclusion] Both UBE and BBE achieve safe and satisfactory clinical consequence in the treatment of grade Ⅰ/Ⅱ L5S1 spondylolisthesis. In contrast, BBE has better reduction capacity than UBE.

Abstract:[Objective] To explore the clinical efficacy of full-visual spinal endoscopy decompression in the treatment of lumbar spinal lateral recess stenosis (LLRS). [Methods] A retrospective study was conducted on 93 patients who had single-segment LLRS treated by full-visual spinal endoscopy decompression in our hospital from June 2021 to June 2023. The clinical and imaging data were evaluated. [Results] All patients had operation performed successfully without change of surgical approach. However, one patients suffered from dural sac tear during the operation, 2 presented residual low back and leg pain, and 2 patients got aggravated lower extremity numbness after the operation. With time before operation, 3 months postoperatively and at the latest follow-up lasted for (14.9±2.3) months in a mena, the VAS scores of lumbago [(4.7±0.8) score, (1.8±0.4) score, (1.1±0.2) score, P＜0.001], VAS of leg pain [(5.8±1.2) score, (1.7±0.5) score, (1.0±0.2) score, P＜0.001] and the ODI [(53.1±6.4) score, (22.3±3.8) score, (13.8±2.4) score, P＜0.001] significantly decreased, while the spinal canal area [(1.4±0.4) cm² , (2.1±0.2) cm² , (2.1±0.2) cm² , P＜0.001], and the anteroposterior diameters of the lateral recess [(2.4±0.3) mm, (4.3±0.4) mm, (4.2±0.4) mm, P＜0.001] significantly increased. The excellent and good rate of clinical outcome was of 96.8% at the last follow-up according to the MacNab criteria. [Conclusion] Full-visual spinal endoscopic decompression for LLRS can effectively and relatively safely relieve the nerve root compression in the lateral recess, and alleviate the symptoms of low back and leg pain.

Abstract:[Objective] To explore the clinical efficacy of improved unilateral biportal endoscopy (UBE) in the treatment of spinal epidural abscess (SEA). [Methods] A retrospective study was done on the clinical data of 25 patients who had SEA treated with improved UBE in the two centers from May 2022 to September 2023. The postoperative efficacy and test results were analyzed. [Results] All patients had UBE performed successfully with the average operation time of (162.8±31.2) min, the average intraoperative blood loss of (32.4±11.6) mL, the average hospitalization of (36.0±7.7) days, and followed up for (12.2±0.4) months. With time preoperativly, 3 days after surgery, 1 month after surgery and the last follow-up, the VAS score [(5.6±1.8), (2.8±0.4), (1.6±0.7), (0.8±0.4), P＜0.001] and ODI score [(40.7±11.6), (32.1± 7.5), (24.0±8.8), (12.7±3.8), P＜0.001] were significantly decreased, while the JOA score [(10.2±3.1), (15.4±2.2), (18.6±2.4), (24.6±1.4), P＜ 0.001] was significantly increased. As for laboratory test, the CPR [(78.3±21.4) mg/L, (60.1±5.3), (8.0±2.7) mg/L, (5.3±2.0) mg/L, P＜0.001] and ESR [(35.4±9.2) mm/h, ( 28.3±4.8) mm/h, (18.9±4.1) mm/h, (7.6±1.8) mm/h, P＜0.001] were significantly declined over time preoperatively, 3 days after surgery, 1 month after surgery and the last follow-up. [Conclusion] SEA can achieve satisfactory clinical consequence through the improved UBE technique combined with full course antibiotics.

Abstract:[Objective] To evaluate the clinical efficacy of Longji acupuncture for lumbar facet disorder and explore its potential mechanism. [Methods] From November 2024 to April 2025, a toal of 81 patients underwent Longji acupuncture for lumbar facet syndrome. Clinical examinations, as well as infrared thermography and lumbar AP/LAT X-ray were conducted before treatment, 1 hour after the first treatment, and after the last treatment. The clinical and auxiliary examination data were evaluated. [Results] During the treatment process, no serious adverse events occurred in anyone of the 81 patients. With time elapsed before the first treatment, 1 hour after the first treatment, and time after the last treatment, the pain VAS [(6.5±0.8) score, (3.8±0.7) score, (1.4±0.6) score, P=0.002] and ODI index [(56.7±5.3)%, (24.6±4.4)%, (6.5±3.9)%, P=0.043] decreased significantly, while the ROM of the lumbar spine in all directions increased significantly (P＜ 0.001). At the latest follow-up lasted for 3~6 months, 69 patients were cured, 9 improved and 3 relapsed among the 81 patients, with overall effective rate of 96.3%. In terms of auxiliary examinations, the average relative temperature at the acupuncture site [(1.9±0.9)℃, (1.4± 0.7)℃, (1.1±0.7)℃, P＜0.001] and the abnormal high-temperature area [(1.3±0.7)℃, (0.8±0.8)℃, (0.5±0.4)℃, P=0.003] decreased significantly (P＜0.05). The adverse signs seen in the images after the last treatment, including unequal spinous process gap, lumbar scoliosis, and lumbar straightening or kyphosis, were significantly reduced compared with those before treatment (P＜0.05). [Conclusion] The Longji acupuncture may restore the biomechanical balance of the spine by rapidly inhibiting local inflammation and reducing soft tissue tension, and has both immediate and sustained analgesic effects.

Abstract: [Objective] To evaluate the early outcome of static neck exercise after anterior cervical discectomy and fusion (ACDF). [Methods] A retrospective research was done on 104 patients who had cervical spondylosis treated by ACDF from March 2022 to February 2024. According to doctor-patient communication, 52 patients were added static neck exercise on the basis of routine rehabilitation exercise in the perioperative period (the combined group), while the other 52 patients only underwent routine rehabilitation exercise (the routine group). The clinical and imaging data were compared between the two groups. [Results] The combined group proved significantly superior to the routine group in terms of the first time of getting out of bed, the first time of eating and hospital stay (P＜0.05). In addition, the combined group was significantly better than the routine group in terms of VAS score [(2.7±0.5) vs (3.2±0.6), P＜0.001] and NDI score [(32.6± 3.4) vs (37.7±4.5), P＜0.001], and JOA score [(12.8±3.4) vs (10.2±3.9), P=0.001] 1 week postoperatively. Regarding imaging, the combined group measured significantly less prevertebral soft tissue thickness than the conventional group 1 week after surgery [(10.2±1.4) mm vs (11.0±1.7) mm, P=0.010]. Moreover, the combined group had significantly lower incidence of axial symptoms than the conventional group (P＜0.05). [Conclusion] Static neck exercise does promote the early recovery after ACDF, reduce the cervical soft tissue swelling, and reduce the incidence of axial symptoms.