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XU Zeng-mao, FENG Bo, ZHANG Ji-jiang, WANG Xin, TIAN Lin, DAI Guo-hua, WANG Kai-wei, LIU Jie, HU Peng
2026,34(10):865-871, DOI: 10.20184/j.cnki.Issn1005-8478.120669
Abstract:
[Objective] To compare the clinical efficacy of unilateral biportal endoscopy (UBE) versus posterior cervical single-door laminoplasty (PCSDL) in the treatment of unilateral cervical spondylotic radiculopathy (CSR). [Methods] A retrospective study was done on 86 patients who had CSR treated surgically in Department of Spine Surgery, Affiliated Hospital, Binzhou Medical University and the Department of Orthopedics, People's Hospital of Yuncheng County from October 2021 to September 2024. According to the communication between doctors and patients, 43 patients were treated with UBE, while the other 43 patients were treated with PCSDL. The perioperative, follow-up, and imaging data of the two groups were compared. [Results] The UBE group proved significantly superior to the PCSDL group in terms of operation time [min, (116.3±22.2) vs (189.8±27.7), P<0.001], intraoperative blood loss [mL, (58.8±9.31) vs (155.2±10.4), P<0.001], total incision length [cm, (2.7±0.7) vs (9.3±1.1), P<0.001], time to get off bed [d, (2.0±0.4) vs (2.4 0.5), P<0.001], and hospital stay [d, (6.9±1.5) vs (11.5±3.8), P<0.001], but the former consumed significantly more intraoperative fluoroscopy than the latter [times, (5.0±0.6) vs (1.4±0.5), P<0.001]. All patients in both groups were followed up for more than 12 months, and there was no a statistically significant difference in the time to resume full weight-bearing activity after surgery between the two groups (P>0.05). Compared with those preoperatively, the VAS scores of neck pain and upper limb pain, NDI and JOA score in both groups significantly improved at 3 months after operation and the last follow-up (P<0.05). At any corresponding time points, there were no statistically significant differences in the above indicators between the two groups (P>0.05). Regarding to imaging, the UBE group had a significantly less area of the spinal canal than the PCSDL group [mm2, (104.7±10.8) vs (117.2±14.5), P<0.001], whereas no significant differences were found in intervertebral foramen area and cervical lordosis between the two groups at the last follow-up (P>0.05). [Conclusion] Both UBE and PCSDL have high safety and reliability in the treatment of CSR. The UBE has advantage of minimally invasive surgery, such as shorter surgical incision, less intraoperative blood loss, shorter operation time, and faster postoperative recovery over the PCSDL.
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TU Shao-chen, LIN Yan-bin, XIONG Guo-sheng, XU Yang-kai, YE You-you, FAN Cun-yi
2026,34(10):872-877, DOI: 10.20184/j.cnki.Issn1005-8478.12037A
Abstract:
[Objective] To explore the factors related to residual back pain (RBP) after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). [Methods] A retrospective study was done on 324 patients who had single-segment OVCF treated with PVP in our department from September 2021 to December 2024. The postoperative RBP was defined as the average visual analogue scale (VAS) ≥4 at 1 day, 1 week and 1 month after surgery. Univariate comparisons were made between the RBP group and non-RBP (NRBP) groups for relevant variables, and multivariate logistic regression analysis was used to explore the risk factors related to RBP. [Results] Among the 324 patients, 98 were fall into the RBP group, accounting for 30.3%, while the remaining 226 were included in the NRBP group. As consequence of univariate comparisons, the RBP group proved significantly greater than the NRBP group in terms of the ratios of intravertebral vacuum cleft (IVC) on preoperative imaging [n, yes/no, (10/88) vs (11/215), P=0.037], the thoracolumbar fascia injury sign on preoperative imaging [n, yes/no, (52/46) vs (68/158), P<0.001], symptomatic Schmorl nodes (SSNs) on preoperative imaging [n, yes/no, (34/64) vs (17/209), P<0.001], and poor bone cement distribution after PVP [n, unsatisfactory/satisfactory, (13/85) vs (11/215), P=0.008] were significantly higher in the RBP group than in the NRBP group. As for logistic regression analysis, the preoperative imaging SSNs sign (OR=6.453, P<0.001), unsatisfactory bone cement distribution after PVP (OR=3.123, P=0.013), and preoperative imaging thoracolumbar fascia injury sign (OR=2.536, P=0.001) were the independent risk factors for RBP after PVP. [Conclusion] The preoperative imaging SSNs sign and thoracolumbar fascia injury sign, as well as poor bone cement distribution after surgery are independent risk factors of RBP after PVP for OVCFs. Surgeons should pay attention to these risk factors and take corresponding measures to improve the surgical outcomes.
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ZHANG Bo-bo, ZHANG Zhan, SONG Zhong-wei, YANG Yi-min
2026,34(10):878-883, DOI: 10.20184/j.cnki.Issn1005-8478.120352
Abstract:
[Objective] To compare the clinical outcome of ipsilateral secondary pedicle puncture and bone cement filling versus the contralateral counterpart for poorly distributed bone cement in the unilateral percutaneous vertebroplasty (PVP). [Methods] A total of 76 patients who had unsatisfactory bone cement distribution and requiring secondary filling in unilateral PVP were included into this prospective study, and were randomly divided into two groups by lottery. Of them, 38 patients received ipsilateral secondary pedicle puncture and filling bone cement (the ipsilateral group), the other 38 patients underwent contralateral secondary pedicle puncture and filling bone cement (the contralateral group). The perioperative, follow-up, and imaging data of the two groups were compared. [Results] All patients in both groups had the secondary puncture and bone cement filling performed smoothly without serious complications, such as bone cement leakage. The ipsilateral group proved significantly superior to the contralateral group in terms of operation time [min, (35.1±1.6) vs (47.6±1.7), P<0.001], secondary puncture time [min, (11.1±1.0) vs (22.7±1.4), P<0.001], the number of X-ray exposures during the secondary operation [times, (8.4±0.9) vs (13.2±0.9), P<0.001], and hospitalization cost [10 k yuan, (1.7±0.1) vs (2.1±0.1), P<0.001]. However, there were no statistically significant differences in the amount of bone cement injection, the final distribution of bone cement, the postoperative ambulation time and the hospitalization time between the two groups (P>0.05). The average follow-up period lasted for (15.4±1.1) months, and there was no a statistically significant difference in the time to regain full weight-bearing between the two groups (P>0.05). Both groups showed significant improvement in VAS and ODI scores over time (P<0.05), whereas there were no statistically significant differences in the above scores between the two groups at any time points accordingly (P>0.05). As for terms of imaging, the anterior height of the injured vertebra and the local Cobb angle were significantly improved in both groups 1 week and the last follow-up time compared with those preoperatively (P<0.05), whereas which proved not significantly different between the two groups at any time points accordingly (P>0.05). [Conclusion] As the bone cement distribution is poor in the first unilateral vertebroplasty, secondary pedicle puncture and bone cement filling on both the ipsilateral side and traditional contralateral side do relieve pain, improve function, and enhance the quality of life of patients. In contrast, the secondary ipsilateral operation has the advantages of shortening the operation time, reducing the number of intraoperative X-ray exposures, and lowering the surgical cost.
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LIN Li-qun, JIANG Chao, SUN Yan, LI Da-peng, CAO Xing-bing, SUN Ji-fu
2026,34(10):884-890, DOI: 10.20184/j.cnki.Issn1005-8478.120083
Abstract:
[Objective] To compare the clinical efficacy of unilateral biportal endoscopic-posterior cervical foraminotomy (UBE-PCF) verus anterior cervical decompression and fusion (ACDF) for single-segment cervical spondylotic radiculopathy. [Methods] A retrospective study was done on 71 patients who received surgical treatment for single-segment cervical spondylotic radiculopathy in our department from April 2020 to April 2023. According to the communication between doctors and patients, 37 patients were treated with UBE, while the other 34 patients with ACDF. The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients had the corresponding operations performed smoothly. The UBE group was significantly superior to the ACDF group in terms of operation time [min, (48.7±3.9) vs (67.1±4.8), P<0.001], total incision length [cm, (1.8±0.1) vs (4.0±0.2), P<0.001], intraoperative blood loss [mL, (35.4±2.8) vs (44.8±2.7), P<0.001], intraoperative fluoroscopy [times, (3.5±0.6) vs (4.8±0.9), P<0.001], hospital stay [days, (5.7±1.7) vs (8.1±1.8), P<0.001], and the incidence of early complications [n (%), 1 (2.7) vs 4 (11.8), P<0.001]. All patients were followed up for an average of (16.4±1.7) months, and there was no statistically significant difference in the time to regain full weight-bearing activity between the two groups (P>0.05). The VAS scores for neck and upper limb pain, NDI, and JOA scores were significantly improved in both groups at 6 months postoperatively and at the last follow-up compared with those preoperatively (P<0.05), whereas which proved not statistically significant between the two groups at any time points accordingly (P>0.05). As for lab test, there was no statistically significant difference in CK and CRP between the two groups before surgery and 3 days after surgery (P>0.05). Regarding imaging, there was no statistically significant difference in foraminal area, intervertebral disc height, and cervical lordosis angle between the two groups before surgery (P>0.05). However, the UBE-PCF was significantly better in term of foraminal area [mm2, (46.6±0.9) vs (41.0±0.8), P<0.001], conversely, significantly inferior to the ACDF group in intervertebral disc height [mm, (4.4±0.3) vs (5.2±0.4), P<0.001] and cervical lordosis [°, (14.0±0.5) vs (14.5±0.5), P<0.001] at the latest follow-up. [Conclusion] UBE-PCF is a relatively safe and effective surgical method for the treatment of single-segment cervical spondylotic radiculopathy.
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HU Peng, ZHONG Yan-long, ZOU Rui-fan, YAO Hao-qun
2026,34(10):891-896, DOI: 10.20184/j.cnki.Issn1005-8478.120294
Abstract:
[Objective] To compare the clinical efficacy of lamina re-implantation versus pedicle screw fixation after laminectomy in the treatment of thoracic ossification of the ligamentum flavum (TOLF). [Methods] A retrospective study was conducted on 54 patients who underwent surgical treatments for TOLF at the Orthopedic Hospital of the First Affiliated Hospital of Nanchang University from January 2020 to December 2023. According to the preoperative doctor-patient communication, 21 patients underwent thoracic ligamentum flavum osteophyte resection and laminoplasty with re-implantation (the re-implantation group), while the other 33 patients underwent thoracic laminectomy and pedicle screw fixation (the fixation group). The perioperative, follow-up, and imaging data of the two groups were compared. [Results] All patients in both groups had the matched surgical procedures performed successfully. The re-implantation group proved significantly superior to the fixation group in terms of operation time [min, (153.4±41.1) vs (222.4±131.2), P=0.031], intraoperative blood loss [mL, (309.5±172.2) vs (570.0±482.5), P=0.018], and intraoperative fluoroscopy [times, (3.5±0.8) vs (6.1±1.0), P=0.018], whereas there were no statistically significant differences in total incision length, time to ambulation, hospital stay, and complication rate between the two groups (P>0.05). All patients were followed up for more than 12 months, and the re-implantation group achieved full weight-bearing activity significantly earlier than the fixation group [days, (37.1±9.1) vs (44.5±10.0), P=0.009]. Compared with those preoperatively, both groups showed significant improvements in JOA, ODI scores, and ASIA grades at the last follow-up (P<0.05). At the last follow-up, the reimplantation group was significantly better than the fixation group regarding ODI [%, (25.8±12.3) vs (37.2±14.4), P=0.004], while there were no statistically significant differences in JOA score and ASIA grade between the two groups (P>0.05). With respect of imaging, the re-implantation group had significantly greater intervertebral space height than the fixation group at the last follow-up [mm, (6.0±1.0) vs (5.5±0.8), P=0.039], while no statistically significant differences were found in thoracic kyphosis angle, dural sac area, and spinal canal area between the two groups (P>0.05). [Conclusion] Both surgical methods can promote the recovery of neurological function. The re-implantation has advantages over the fixation in terms of shorter operation time, less intraoperative blood loss, and earlier recovery of full weight-bearing activity, which can reduce postoperative low back pain and stiffness and improve the quality of life of patients.
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ZHANG Sheng, YANG Zai-chao, TIAN Jin-cai, XUE Wang-dong, HUANG Wei, LI Wen-bin, ZHOU Hai-jun, CHEN Jian
2026,34(10):897-902, DOI: 10.20184/j.cnki.Issn1005-8478.120061
Abstract:
[Objective] To explore the clinical efficacy of Tianji orthopedic robot-assisted percutaneous endoscopic lumbar discectomy (PELD) in the treatment of single-segment lumbar disc herniation (LDH). [Methods] A retrospective analysis was conducted on 56 patients who underwent PELD for single-segment LDH in our department from May 2022 to March 2024. According to the communication between doctors and patients, 26 cases were treated with Tianji orthopedic robot-assisted PELD (the robot group), while the other 27 cases were treated with traditional manual PELD (the manual group). The perioperative, follow-up, and imaging data of the two groups were compared. [Results] Both groups had corresponding PELDs performed successfully, with no statistically significant differences in the operation time, channel establishment time, total incision length, intraoperative blood loss, ambulation time, and hospital stay between the two groups (P>0.05). The robot group proved significantly superior to the manual group in term of success rate of one-time puncture [n (%), 26 (100) vs 3 (11.1), P<0.001], despite of the fact that the former consumed significantly more number of intraoperative fluoroscopy than the latter [times, (105.7±1.5) vs (20.1±2.6), P<0.001]. The patients in both group were followed up for an average of (12.9±2.2) months, and there was no statistically significant difference in the time to resume full weight-bearing activities between the two groups (P>0.05). The VAS scores for back pain and leg pain, as well as ODI and JOA scores in the two groups significantly improved over time (P<0.05), which proved not statistically significant between the two groups at any corresponding time point (P>0.05). Regarding imaging, the vertebral canal area of the affected segment in both groups significantly increased (P<0.05), while the intervertebral space height and lumbar lordosis angle remained not significantly changed at the latest follow-up compared with those preoperatively (P>0.05). At any corresponding time points, there were no statistically significant differences in the above imaging indicators between the two groups (P>0.05). [Conclusion] Both robot-assisted and traditional manual PELD can achieve satisfactory clinical efficacy in the treatment of single-segment LDH. In contrast, the targeted puncture under robot-assisted guidance does establish the working channel more precisely and safely.
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XIONG Jun-yan, SHENG Zhi-tian, QIU Guo-liang, ZHANG Hua-ming
2026,34(10):903-908, DOI: 10.20184/j.cnki.Issn1005-8478.120282
Abstract:
Primary cervical intervertebral space infection refers to infectious lesions between the cervical intervertebral discs and adjacent vertebral bodies with an unclear source of infection. It is relatively rare in neurosurgery and has low specificity in clinical manifestations, making it extremely prone to missed diagnosis and misdiagnosis. There is no definitive treatment standard in clinical practice. This article reports a patient treated with autologous iliac bone graft fusion combined with plate internal fixation for chronic primary cervical intervertebral space infection, and conducts a literature review based on the clinical characteristics of this disease, summarizing the characteristics of the onset, diagnosis, differential diagnosis, and treatment methods of cervical intervertebral space infection, providing more experience for the treatment of this disease.
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CAI Yi-jie, ZHANG Bo, WANG Wei, XIONG Cheng-jie
2026,34(10):909-914, DOI: 10.20184/j.cnki.Issn1005-8478.120193
Abstract:
Intervertebral disc degeneration (IDD) constitutes a prevalent spinal pathology driven by multi-factorial etiologies, including aging, postural abnormalities, and chronic mechanical overload. Conventional biomechanical approaches often fall short in capturing the intricacies of the degenerative cascade, particularly in reproducing pathological progression and quantitatively assessing therapeutic interventions. The finite element method (FEM), as an advanced computational modeling technique, provides a robust framework for simulating the biomechanical behavior of intervertebral discs under both physiological and pathological conditions. This review delineates the current advancements in FEM-based IDD research, emphasizing developments in model construction, degeneration-related mechanical characterization, and in silico evaluation of diverse treatment modalities. FEM has demonstrated significant value in elucidating alterations in stress distribution and spinal stability across the degenerated and adjacent segments, particularly in the context of spinal fusion, dynamic stabilization, and implant innovation. Future directions include the integration of artificial intelligence and multi-omics data with FEM, coupled with clinical validation, to enhance its applicability in precision diagnostics and individualized therapeutic planning.
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LIU Yue, ZHU Zhi-tao, LIU Hai-tao, WANG Jin-wu
2026,34(10):915-920, DOI: 10.20184/j.cnki.Issn1005-8478.120122
Abstract:
A systematic review was conducted on literature about traditional scoliosis orthoses and 3D-printed scoliosis orthoses from 2015 to 2025. The 3D-printed orthoses are commonly made by fused deposition modeling (FDM) and selective laser sintering (SLS) technologies with mostly polycarbonate (PC) and polyamide (PA). They can be used to correct spinal curvature in term of Cobb angle, improve the mental health of teenagers, correct sagittal and coronal plane imbalance, and improve wearing compliance. The 3D-printed orthoses are superior to traditional orthoses in terms of production efficiency and accuracy. In the future, 3D-printed scoliosis orthoses will explore new directions in technology and application, involving multi-technology integration, combined with finite element analysis and artificial intelligence to achieve precise customization. In addition, with developing lightweight, high-strength, biocompatible and low-cost new materials, integrating sensing and internet of things technologies, the dynamic monitoring and intelligent adjustment and process detection will achieve digital therapy integration.
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HE Xue-feng, TIAN Wen-ping, GAO Han, MA Chang-zhi
2026,34(10):921-925, DOI: 10.20184/j.cnki.Issn1005-8478.110565
Abstract:
Diabetic foot ulcer is one of the serious complications of diabetes mellitus, in serious condition, which might lead to amputation, even death. The long-term delay healing of the ulcer not only impact the quality of life of patients, but also raise the burden of family and society. There are many medical and surgical methods for the treatment of diabetic foot ulcers in clinical practice, but they remain unsatisfactory. At present, the control and treatment of diabetic foot ulcer wounds is still a difficult problem and challenge for clinicians. In recent years, related studies on local application of insulin to promote wound healing have been gradually carried out, wit remarkable consequence. This article analyzes and summarizes the mechanism of refractory diabetic foot ulcer and the role of local insulin in the treatment of diabetic foot ulcer through a literature review, to provide a reference for further research on the effective application of local insulin in the treatment of diabetic foot ulcer.
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BAI Shu-cai, WANG Sun, LI Xiao-hui
2026,34(10):926-930, DOI: 10.20184/j.cnki.Issn1005-8478.110909
Abstract:
Steroid-induced osteonecrosis of the femoral head (SONFH) is a common and highly disabling and deformative disease in orthopedics. The pathogenesis of steroid-induced osteonecrosis of the femoral head remains unclear. In recent years, more and more studies have confirmed that long-term chronic glucocorticoid use causes increased polarization of pro-inflammatory macrophages (M1 type) and inhibits the polarization of anti-inflammatory macrophages (M2 type), leading to the continuous production of chronic inflammatory mediators, which further causes bone immune imbalance. This process might be an important pathogenic mechanism of SONFH and is regulated by multiple signaling pathways. This article reviews the mechanism and related signaling pathways of macrophage polarization in SONFH, providing ideas for further prevention and treatment of SONFH.
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GAO Xin-yi, XUE Xiao-feng, SHANG Jin, XIAO Yu-xin, FENG Jia-rui, ZHAO Hong-kai, QIAO Xiao-hong
2026,34(10):931-937, DOI: 10.20184/j.cnki.Issn1005-8478.120050
Abstract:
[Objective] To explore the effect of Bi-Tong decoction on spinal cord injury (SCI) in rats by using network pharmacology and animal experiments. [Methods] The active chemical components and targets of Bi-Tong decoction were retrieved from TCMSP and Uniprot databases. SCI-related genes were obtained from GeneCards, CTD, and DrugBank databases. The drug-gene-disease network was constructed using Cytoscape 3.10.0 software. Protein-protein interaction analysis was performed using the String database. GO analysis, and then KEGG pathway enrichment analysis were conducted using the David database. In addition, thirty-five SD rats were randomly divided into the sham operation group, model group, low-dose group, medium-dose group, and high-dose group. SCI models were established in the model group and each drug administration group. The Basso-Beattie-Bresnahan (BBB) score of rats was recorded, and blood parameters were measured. [Results] In term of network pharmacology, a total of 350 drug targets were screened, with 258 intersection targets between drugs and diseases. Core targets included TNF-α, IL-1β, TP53, ALB, and PPARG, and core components included quercetin, kaempferol, caffeic acid, luteolin, and formononetin. In term of animal experiments, the BBB score in the high-dose group was significantly increased compared with that in the model group at 21 days [points, (13.3±1.0) vs (14.9±0.7), P<0.001], whereas which in the medium-dose group [points, (13.7±1.0) vs (15.6±1.0), P<0.001] and the high-dose group [points, (13.7±1.0) vs (16.1±1.1), P<0.001] were significantly increased compared with that in the model group at 28 days. Regarding blood tests, TNF-α, IL-1β, IL-6, PLA2, MDA, and PGE2 were significantly increased (P<0.05), while SOD was significantly decreased (P<0.05) in the model group, low-dose group, medium-dose group, and high-dose group compared with that in the sham group. Compared with those in the model group, the TNF-α, IL-1β, PLA2, MDA, and PGE2 were significantly decreased in the medium-dose group and high-dose group (P<0.05), whereas the IL-6 was significantly decreased in the high-dose group (P<0.05), and SOD was significantly increased in the medium-dose group and high-dose group (P<0.05). [Conclusion] The Bi-Tong decoction does eliminate oxygen free radicals and promote the recovery of spinal cord function to a certain extent.
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MA Bin-xiang, TIAN Hong-jing, SHI Na-na, LIU Xin-feng, LEI Ling, GUO Jie, ZHANG Yan-jun
2026,34(10):938-942, DOI: 10.20184/j.cnki.Issn1005-8478.120708
Abstract:
[Objective] To introduce the surgical technique and preliminary clinical outcome of unilateral biportal endoscopic discectomy for thoracic ossified intervertebral disc protrusion through the paravertebral approach. [Method] As portals for unilateral biportal endoscopy was established with continuous normal saline irrigation, the T12 facet tip was identified under the endoscope and the corresponding intervertebral foramen area was burred and expanded to expose the ossified lesion gradually from the intervertebral foramen to the spinal canal. With the up-low boundary of the lower edge of the T11 pedicle and the upper edge of the T12 pedicle, and the in-out boundary of the midpoint of the intervertebral foramen to the left and right ligamentum flavum, the protruded and ossified nucleus pulposus was removed by a burr with protective sheath inferolateral to the dura mater. After proper compression achieved, a drainage tube was placed and the incisions were sutured and bandaged. [Results] During the operation, the ossified intervertebral disc compressing the spinal cord and the hyperplastic ligamentum flavum were successfully removed. On the second day after the operation, the drainage volume was of 20 mL and the drainage tube was removed. The postoperative lumbar CT and MRI showed that the protruded and ossified nucleus pulposus tissue in the T11~T12 segment had been properly removed, and the compression of the nerve root and the dural sac was significantly relieved. Three days after the operation, the patient reported significant improvement in bilateral lower limb pain and weakness, with VAS score of 4 and remarkably improved neurological motor function. [Conclusion] The unilateral biportal endoscopic technique through the paravertebral approach greatly overcomes the operational blind area caused by the narrow thoracic spine anatomy, avoids the complex nerve root distribution in the spinal canal, reduces the risk of traction on the spinal cord, and achieves comprehensive spinal decompression.
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XIE Gui-si, ZHU Cheng-yue, SHEN Jun-feng, LIANG Jia-ming, ZHANG Wei
2026,34(10):943-947, DOI: 10.20184/j.cnki.Issn1005-8478.120595
Abstract:
[Objective] To evaluate the primary clinical efficacy of unilateral biportal endoscopy (UBE) interbody fusion with double cages in the treatment of lumbar spondylolisthesis. [Methods] A retrospective study was conducted on 13 patients who underwent UBE interbody fusion with double lumbar interbody cages for lumbar spondylolisthesis from June 2021 to June 2023. The clinical and radiological data were evaluated. [Results] All patients underwent successful surgery with operation time of (152.6±33.4) min and intraoperative blood loss of (90.4±20.2) mL, without severe complications. The 13 patients were followed up for (13.3±1.4) months in a mean. The VAS for low back pain [point, (6.6±1.2), (2.7±0.8), (2.6±1.0), (2.5±1.1), P<0.001], VAS for leg pain [point, (6.9±1.7), (2.8±0.8), (2.6±1.1), (2.6±0.9), P<0.001], and ODI [%, (52.7±10.2), (29.3±10.4), (28.8±8.8), (27.5±7.3), P<0.001] significantly decreased over time preoperatively, 1 month postoperatively, 6 months postoperatively, and the last follow-up. Radiologically, compared with those preoperatively, the intervertebral space height [mm, (7.7±3.2), (11.5±2.6), P<0.001], the slippage ratio of the affected segment [%, (17.1±5.9), (11.0±3.0), P<0.001], and the lumbar lordosis angle [°, (27.5±14.2), (35.8±8.8), P<0.001] were significantly improved at the last follow-up. In addition, all the 13 patients achieved bony fusion of the affected intervertebral space, with no obvious cage displacement or subsidence, and no loosening or fracture of the pedicle screws at the last follow-up. [Conclusion] This UBE interbody fusion with double cages for the treatment of lumbar spondylolisthesis has significant clinical efficacy and high surgical safety. Therefore, it provides a new minimally invasive option for the treatment of lumbar spondylolisthesis.
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TONG Zhi-wei, AN Guo-bin, TIAN Xian-peng, ZHANG Xi-shan
2026,34(10):948-952, DOI: 10.20184/j.cnki.Issn1005-8478.130023
Abstract:
[Objective] To explore the correlation between the clinical symptoms of type Ⅱ Modic changes and the expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and cyclooxygenase-2 (COX-2) in the cartilage endplates at the responsible segments. [Methods] From January 2024 to June 2025, 63 patients who underwent minimally invasive transforaminal lumbar interbody fusion due to single-segment lumbar degenerative diseases in our hospital were included in this study. According to whether or not the type II Modic changes in the responsible segments endplate were found in MRI before surgery, the patients were divided into the changed group (29 cases), and the unchanged group (34 cases). During the operation, the cartilage endplates were collected for histological and immunohistochemical assay. The preoperative clinical scores and the cartilage endplate detections of the two groups were compared and analyzed for their correlation. [Results] The changed group proved significantly higher preoperative VAS score of lumbar pain [points, (6.5±1.4) vs (3.6 ± 0.9), P<0.001] and the ODI index [%, (41.5±3.9) vs (35.9±3.4), P<0.001] than the unchanged group. As results of cartilage endplate immunohistochemical detections, the changed group was significantly higher than the unchanged groups in terms of expression levels of TNF-α [H-score, (132.7±6.7) vs (50.1±3.7), P<0.001], IL-1β [H-score, (99.4±5.8) vs (38.8±4.6), P<0.001], and COX-2 [H-score, (120.8±7.1) vs (45.2±6.6), P<0.001]. As for pairwise correlation analysis, the VAS score of lumbar pain and the ODI index were significantly positively correlated with the expression levels of TNF-α, IL-1β, and COX-2 (P<0.05), with the strongest correlation with COX-2. [Conclusion] The Type II Modic changes are closely related to the clinical symptoms of patients. The pathogenesis of this change might be due to the high expression of local inflammatory factors.
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LIU Bin, ZHANG Ting-wei, ZHOU Ji-ping, LI Jia-jia, LIU Yong-qiang, SUN Hai-chao, WANG Li-jun, JIANG Ze-wei
2026,34(10):953-957, DOI: 10.20184/j.cnki.Issn1005-8478.120856
Abstract:
[Objective] To compare the clinical outcomes of unilateral biportal endoscopic (UBE) discectomy for lumbar disc herniation (LDH) with and without annular repair. [Methods] From October 2023 to February 2025, a total of 80 patients with LDH were included in this study and all underwent UBE discectomy. Based on doctor-patient communication, 36 patients received annular suture after UBE discectomy, while the remaining 44 patients only underwent UBE discectomy without annular suture. The perioperative and follow-up data of the two groups were compared. [Results] All patients in both groups had the consistent surgeries performed successfully without serious complications. The suture group consumed significantly higher operation time [min, (66.7±11.3) vs (53.4±12.9), P=0.032] and blood loss [mL, (56.6±19.1) vs (45.6±21.3), P=0.023] than the non-suture group. All patients were followed up for more than 10 months. The VAS scores for low back pain and leg pain, as well as the ODI score significantly decreased in both groups over time (P<0.05), whereas which proved not statistically significant between the two groups at any time points accordingly (P>0.05). During the follow-up period, no recurrence was observed in the suture group, while 2 cases (4.5%) recurred in the non-suture group, whose symptoms improved after conservative treatment without revision surgery. [Conclusion] UBE discectomy combined with annular suture for LDH can close the annular defect and potentially reduce the recurrence rate, but it increases the operation time and blood loss. Clinical decisions should be individualized based on patient conditions.
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LONG Jun-lin, TANG Ming-xing, GAO Qi-le, GUO Chao-feng
2026,34(10):958-960, DOI: 10.20184/j.cnki.Issn1005-8478.120059
Abstract:
