ObjectiveTo develop a nomogram model for the prediction of the risk of prolonged length of hospital stay (LOS) in spinal fusion patients.MethodsA retrospective cohort study was carried out on 6272 patients who had undergone spinal fusion surgery. Least absolute shrinkage and selection operator (LASSO) regression was performed on the training sets to screen variables, and the importance of independent variables was ranked via random forest. In addition, various independent variables were used in the construction of models 1 and 2. A receiver operating characteristic curve was used to evaluate the models' predictive performance. We employed Delong tests to compare the area under the curve (AUC) of the different models. Assessment of the models' capability to improve classification efficiency was achieved using continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). The Hosmer-Lemeshow method and calibration curve was utilised to assess the calibration degree, and decision curve to evaluate its clinical practicality. A bootstrap technique that involved 10 cross-validations and was performed 10,000 times was used to conduct internal and external validation. The were outcomes of the model exhibited in a nomogram graphics. The developed nomogram was validated both internally and externally.ResultsModel 1 was identified as the optimal model. The risk factors for prolonged LOS comprised blood transfusion, operation type, use of tranexamic acid (TXA), diabetes, electrolyte disturbance, body mass index (BMI), surgical procedure performed, the number of preoperative diagnoses and operative time. The diagnostic performance of the nomogram model was satisfactory, with AUC values of 0.784 and 0.795 for the internal and external validation sets, respectively. Model discrimination was favourable in both the internal (C-statistic, 0.811) and external (C-statistic, 0.814) validation sets. Calibration curve and Hosmer-Lemeshow test showed acceptable agreement between predicted and actual results. The decision curve shows that the model provides net clinical benefit within a certain decision threshold range.ConclusionsThis study developed and validated a nomogram to identify the risk of prolonged LOS in spinal fusion patients, which may help clinicians to identify high-risk groups at an early stage. Predictors identified included blood transfusion, operation type, use of TXA, diabetes, electrolyte disturbance, BMI, surgical procedure performed, number of preoperative diagnoses and operative time.

目的 探讨颈部脊髓损伤(cervical spinal cord injury,CSCI)术后感染的预后因素.方法 回顾性分析2017 年1 月～2021 年11 月我院脊柱外科手术治疗207 例CSCI的临床资料,按照病例纳入和排除标准,共纳入 207 例.根据患者术后是否发生感染分为感染组和未感染组,对年龄、性别、术前脊髓损伤美国脊髓损伤协会(American Spinal Injury Association,ASIA)分级、受伤原因、损伤节段数、手术方式、术后是否转入重症监护室(intensive care unit,ICU)、术前是否采取激素冲击治疗、术前是否存在合并伤、是否存在合并症、术中出血量、受伤至入院手术时间、术前白蛋白(albumin,ALB)、术前血红蛋白(hemoglobin,Hgb)等变量进行单因素分析,将单因素分析结果中P<0.20 的变量纳入二元logistic多因素回归分析.结果 单因素分析P<0.20 的变量:术前ASIA分级、受伤到入院手术时间、术前ALB、术前Hgb、术中出血量、术后是否转入ICU、术前是否使用激素冲击治疗、手术方式和受伤原因.logistic多因素回归分析显示,术前ASIA分级A级(OR =0.424,95%CI:0.278～0.646,P =0.001)、术后转入ICU治疗(OR =4.185,95%CI:1.058～16.554,P =0.041)是CSCI发生术后感染的独立预后因素.结论 术前ASIA A级、术后转入ICU治疗是CSCI患者术后感染的独立预后因素.

目的 探讨人类白细胞抗原(HLA)-B基因rs1058026和rs3819299位点单核苷酸多态性与女性强直性脊柱炎(AS)易感性的相关性.方法 选取108例女性AS患者(病例组)及129例体检正常女性(对照组).比较两组研究对象的一般资料,以及HLA-B基因rs1058026和rs3819299位点基因型和等位基因分布频率.使用Logistic回归模型分析上述基因位点基因型和等位基因与女性AS易感性的相关性.结果 病例组AS家族史比例及HLA-B27阳性比例均高于对照组(均P<0.05),而两组吸烟史比例、饮酒史比例差异均无统计学意义(均P>0.05).HLA-B基因rs3819299位点的等位基因G增加女性的AS发病风险(OR=16.172,P<0.05),相比于基因型TT,rs3819299位点的基因型GT增加女性的AS发病风险(OR=113.877,P<0.05);HLA-B基因rs1058026位点的等位基因和基因型与女性的AS发病风险无关(均P>0.05).结论 HLA-B基因rs3819299位点单核苷酸多态性与女性AS易感性相关,rs3819299位点的等位基因G、基因型GT可能会增加女性AS的发病风险.

目的 观察斜外侧入路腰椎椎间融合术(oblique lumbar interbody fusion,OLIF)治疗后路腰椎椎间融合术后邻近节段退变(adjacent segment degeneration,ASD)的早期临床疗效.方法 回顾性分析18 例因腰椎融合术后ASD行OLIF治疗的患者资料.患者首次手术均行腰椎后路减压植骨融合术,术后24～240 个月发生 ASD,应用单纯OLIF或联合后路椎弓根螺钉内固定、或联合侧方内固定进行治疗.评估其手术情况,并评价术后疗效和相关影像学指标.结果 所有患者均顺利完成手术,术后随访14～30 个月,OLIF手术节段均骨性融合.手术方式采用stand alone 5 例,联合后路椎弓根螺钉内固定 5 例,联合侧方固定 8 例.手术时间为70(50,115)min,术中出血量为50(20,136)mL.所有患者末次随访时的腰腿痛VAS评分及ODI指数较术前均明显降低(P<0.05).影像学测量显示,患者术后手术节段的椎间隙腹侧和背侧高度、椎间孔高度较术前均明显增加(P<0.05).结论 OLIF是治疗后路腰椎椎间融合术后ASD的有效方式,具有良好的早期疗效.

ObjectiveWith advancements in minimally invasive techniques, the use of spinal fusion surgery is rapidly increasing and transfusion rates are decreasing. Routine preoperative ABO/Rh blood type and antibody screening (T&S) laboratory tests may not be appropriate for all spinal fusion patients. Herein, we constructed a nomogram to assess patient transfusion risk based on various risk factors in patients undergoing spinal fusion surgery, so that preoperative T&S testing can be selectively scheduled in appropriate patients to reduce healthcare and patient costs.MethodsPatients who underwent spinal fusion surgery between 01/2020 and 03/2023 were retrospectively examined and classified into the training (n = 3533, 70%) and validation (n = 1515, 30%) datasets. LASSO and multivariable logistic regression were used to analyze risk factors for blood transfusion. Nomogram predictive model was built according to the independent predictors and mode predictive power was validated using consistency index (C‐index), Hosmer–Lemeshow (HL) test, calibration curve analysis and area under the curve (AUC) for receiver operating characteristic (ROC) curve. Bootstrap resampling was used for internal validation. Decision curve analysis (DCA) was applied to evaluate the model's performance in the clinic.ResultsBeing female, age, BMI, admission route, critical patient, operative time, heart failure, end‐stage renal disease or chronic kidney disease (ESRD or CKD), anemia, and coagulation defect were predictors of blood transfusion for spinal fusion. A prediction nomogram was developed according to a multivariate model with good discriminatory power (C‐index = 0.887); Bootstrap resampling internal validation C‐index was 0.883. Calibration curves showed strong matching between the predicted and actual probabilities of the training and validation sets. HL tests for the training and validation sets had p‐values of 0.327 and 0.179, respectively, indicating good calibration. When applied to the training set, the following parameters were found: AUC: 0.895, 95% CI: 0.871–0.919, sensitivity 78.2%, specificity 86.7%, positive predictive value 29.4% and negative predictive value 98.2%. If the model were applied in the training set, 2911 T&S tests (82.4%) would be eliminated, equaling a RMB349,320 cost reduction. The AUC in the internal validation was: 0.879, 95% CI: 0.839–0.927, sensitivity 75.2%, specificity 88.8%, positive predictive value 34.3%, negative predictive value 97.9%, would eliminate 1276 T&S tests (84.2%), saving RMB 153,120. The DCA curve indicated good clinical application value.ConclusionThe nomogram based on 10 independent factors can help healthcare professionals predict the risk of transfusion for patients undergoing spinal fusion surgery to target preoperative T&S testing to appropriate patients and reduce healthcare costs.

Objectives This meta-analysis aims to assess tranexamic acid (TXA) effectiveness and safety in lumbar surgery. Patients and methods Renewals of randomized-controlled trials (RCTs) were conducted utilizing databases of medical literature such as PubMed, China Science and Technology Journal Database, Cochrane Library, China National Knowledge Infrastructure (CNKI), and EMBASE to compare principal and safety endpoints. The risk ratio (RR), standard mean difference (SMD), and 95% confidence intervals (CIs) were calculated. For the evaluation of the quality of the included studies, the Cochrane risk of bias criteria were utilized by two authors. Results In total, 49 articles were enrolled that included 4,822 patients. Of the patients, 2,653 were administered TXA and 2,169 were in the control group. The findings indicated that TXA was capable of significantly lowering postoperative blood loss (PBL), transfusion rate, transfusion volume, total blood loss (TBL), intraoperative blood loss (IBL), and drainage compared to the control group. Besides, hemoglobin (Hb) and hematocrit (Hct) values were higher in the TXA group compared to the control group. As the safety endpoints, TXA significantly reduced D-dimer levels compared to the control group; however, both TXA and control groups had no significant variations in deep venous thrombosis (DVT). Subgroup analysis was administrated according to the administration method of TXA and the operation type and intravenous and topical TXA were combined in the meta-analysis. Conclusion This meta-analysis showed that TXA had the potential to significantly lower PBL, transfusion rate, transfusion volume, TBL, IBL, and drainage compared to the control group. Besides, Hb and Hct values were higher in the TXA group compared to the control group. Its hemostatic potential after lumbar spine surgery is trustworthy. It is still controversial in safety endpoints that TXA can significantly reduce D-dimer compared to the control group, without no significant variations in DVT in both the TXA and control groups.

目的 斜外侧腰椎椎间融合术(简称:OLIF)与微创经椎间孔腰椎椎间融合术(简称:MIS-TLIF)治疗退变性腰椎滑脱症的疗效比较.方法 样本来源:回顾性分析2017年1月至2019年6月在本院行斜外侧腰椎椎间融合术(OLIF组)及微创经椎间孔腰椎椎间融合术(M IS-T L IF组)治疗的单节段I度腰椎滑脱患者,O L IF组采用斜外侧腰椎椎间融合术联合可扩张微创通道系统椎弓根螺钉内固定术,MIS-TLIF采用可扩张微创通道系统经椎间孔腰椎椎间融合术,比较两组术中出血量、手术时间、术后住院天数及并发症情况.结果 OLIF组出血量少于MIS-TLIF组(P<0.05);OLIF组的手术时间比MIS-TLIF组稍长,平均术后住院天数比MIS-TLIF组短,但两项数据差异无统计学意义(P>0.05);OLIF组发生神经根损伤1例,MIS-TLIF组发生神经根损伤1例,发生感染1例,两组并发症比较差异无统计学意义(P>0.05).术前OLIF组的VAS评分和ODI指数与MIS-TLIF组数据接近,不存在统计学对比价值(P>0.05),两组术前术后VAS评分和ODI指数比较均具有统计学价值(P<0.05);术后3个月、6个月OLIF组的VAS评分和ODI指数均优于MIS-TLIF组(P<0.05).结论 斜外侧腰椎椎间融合术治疗单节段腰椎滑脱症临床疗效及安全有效性与微创经椎间孔腰椎椎间融合术相当,但O L IF术出血量更少,住院时间更短,对椎管骚扰及后方结构破坏更少,术后恢复效果更佳.

目的 分析探讨腰椎前路途经手术并发症原因和预防策略,为预后避免出现并发症提供相应的依据.方法 选取广西医科大学第四附属医院2012年3月至2019年1月收治的553例腰椎前路途径手术治疗的患者为研究对象,其中结核病患者269例、肿瘤患者51例、骨折患者i12例、椎间盘炎症患者20例、腰椎滑脱患者32例、腰椎畸形患者69例.对所有患者进行全面的信息统计.结果 在选取的553例进行腰椎前路手术的患者中,在手术之后出现并发症的概率是22.6％,手术之后出现死亡的概率是0.18％.在并发症的发生中,出现主要术后并发症的概率是4.52％,出现次要术后并发症的概率是18.08％;进行一般脊柱手术的患者出现术后并发症的概率为5.1％,其中和前路手术有关联的术后并发症概率是28.8％.出现上腰椎术后并发症的概率要比下腰椎术后并发症的概率更高;所有骨折的患者出现术后并发症的概率要比结核患者、椎间盘炎症患者、腰椎滑脱患者、腰椎畸形患者的术后病症的概率更高;所有骨折的患者以及肿瘤患者术后出现主要并发症的概率要比其他疾病患者的主要并发症的概率更高.结论 腰椎前路途径手术是一项有效性较高且十分安全的方法,能够治疗多种腰椎前方病变类疾病.由于现代外科技术的不断进步和发展,在现代化媒体的辅助下,可最大程度减少患者进行腰椎前路手术之后出现并发症的概率,提高患者的治疗有效性.

目的 比较经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症疗效.方法 将166例腰椎间盘突出症患者随机分为两组,每组83例,对照组采用小切口椎板开窗髓核摘除术,观察组采用经皮椎间孔镜技术.比较两组手术相关指标、疼痛缓解和功能恢复情况、临床疗效及并发症发生情况.结果 患者均获得3个月随访.切口长度、手术时间、术中出血量及住院时间观察组均优于对照组(P＜0.001).术后3个月,两组VAS评分、JOA评分及临床治疗有效率比较差异均无统计学意义(P＞0.05).并发症发生率观察组低于对照组(P＜0.05).结论 经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症临床疗效相当,但经皮椎间孔镜技术损伤少,并发症少,住院时间短.

目的 探讨斜外侧腰椎椎间融合术治疗单节段腰椎退变性疾病的应用效果.方法 选取2017年2月～2018年7月我院60例单节段腰椎退变性患者为研究对象,为患者选用斜外侧腰椎椎间融合术治疗方案进行救治,在为患者实施斜外侧腰椎椎间融合术前后,对患者各项功能进行评估,分析60例单节段腰椎退变性患者治疗情况.结果 治疗后,所得患者运动功能评分、生活自理能力评分、满意度评分数值高于治疗前所得数值,差异有统计学意义(P<0.05).结论 斜外侧腰椎椎间融合术治疗单节段腰椎退变性疾病的应用效果显著,值得应用.

目的 探讨全内脏反位合并腰椎间盘突出症患者行腰椎融合术的效果及是否存在神经根解剖变异.方法 选择本院入院检查确诊为全内脏反位合并腰椎间盘突出并且有明确手术指征的1例患者,经Quadrant通道系统行椎间孔腰椎椎间融合术,探查责任椎间盘节段神经根是否有解剖学变异,评估手术疗效.结果 术中探查见患者L4/5椎间盘切除后双侧神经根与无内脏反位患者无明显解剖变异,术后腰腿痛完全好转,术后1个月、3个月、半年随访均无慢性腰痛残留,术前ODI评分66％,腰腿痛VAS评分8分,术后半年患者ODI评分4％,腰腿痛VAS评分0分.结论 经Quad-rant通道系统行椎间孔腰椎椎间融合术治疗全内脏反位患者的腰椎间盘突出症效果良好.

目的 探讨椎板回植在重建脊柱后柱中的临床应用价值.方法 选取2014年3月-2016年1月我院收治的60例椎管内肿瘤患者为研究对象,采用随机数字表法将其分为对照组及研究组,各30例,对照组实施常规微型钛板固定术椎板部分或全切除术,研究组实施棘突椎板韧带复合体回植术治疗,观察两组手术指标(手术时间、术中失血量、住院时间)、手术效果、术后并发症发生率及术后康复情况.结果 研究组手术时间、术中出血量与对照组相比较无明显差异(P>0.05);但研究组住院时间较对照组明显短(P<0.05);研究组术后总有效率(86.67％)较对照组(63.33％)明显高,研究组并发症总发生率(6.66％)较对照组(27.27％)明显偏低,差异显著(P<0.05);研究组术后6个月椎间隙植骨融合率(100.00％)、1年后椎板骨性融合率(100.00％)较对照组86.21％、83.00％均明显高,差异有统计学意义(P<0.05).结论 椎板回植内固定术可重建椎管内肿瘤患者脊柱后柱结构,手术疗效好,术后并发症少,预后效果佳.

BACKGROUND: The artificial disc requires a height, a width, and a shape as much as possible to be similar to the original intervertebral disc in order to perfectly distribute the load. At present, most of the data are from foreign countries or measured using X-ray and magnetic resonance imaging, but there are some shortcomings. OBJECTIVE: To diagnose the spinal disease and provide data for the design of a native lumbar disc device by measuring the normal lumbar intervertebral disc using computer tomography (CT). METHODS: A total of 2 235 patients who underwent lumbar CT examination in Liuzhou Worker's Hospital from January 2012 to May 2017 were collected and analyzed. There were 62 cases, including 45 males and 17 females, after being strictly met the inclusion and exclusion criteria. From the age of 20, they were divided into four groups: 20-30, 31-40, 41-50 and more than 50 years old. The range was from L1to S1. The measurement index include intervertebral disc anteroposterior diameter, transerverse diameter, disc volume, sagittal anterior, middle and posterior height, coronal left and right height, and interverterbral angle. RESULTS AND CONCLUSION: (1) In terms of age, there was a statistically significant difference in measurement indexes between L1/2, L2/3 and L3/4(P < 0.05). Therefore, the factor of age should be taken into account. However, there was no statistically significant difference between L4/5and L5/S1segments (P > 0.05). (2) There was a statistical difference between the anterior and middle height of the sagittal position in L4/5and L5/S1(P < 0.05). (3) There were statistical differences between the angles of L2/3, L3/4, L4/5, L5/S1intervertebral space (P <0.05), but the difference of angle between L4/5and L5/S1was the most. (4) There was no statistical difference in the height between the left and right sides of the coronal position (P > 0.05). (5) There was statistical difference between the anteroposterior and transverse diameters of the disc on the adjacent cross section (P < 0.05). (6) The results showed that the lower the segment, the smaller the statistical difference between each group. It is indicated that the age difference should be considered on the L1/2, L2/3, and L3/4segments in the design of lumbar disc or interbody fusion. The lumbar artificial intervertebral disc can be placed in the middle or side. The artificial disc should be designed into the wedge shape instead of a rectangle. These will provide a good anatomical basis for the design of domestic lumbar artificial intervertebral discs.

目的 探讨椎板开窗保留脊柱后方复合体术式对腰椎爆裂性骨折的临床应用疗效.方法 回顾性分析腰椎爆裂性骨折患者80例,分为观察组(椎板开窗保留脊柱后方复合体术)和对照组(椎板切开减压术)各40例.观察组40例中男25例,女15例;年龄25~54岁,平均年龄为(31.5±5.1)岁.对照组40例中男23例,女17例;年龄21~56岁,平均年龄为(35.5±2.1)岁.观察两组患者采取不同手术前后的临床症状、疗效和患者生活质量的影响.结果两组患者手术后比较,ODI评分、椎体高度比之间差异具有统计学意义(P<0.05),Cobb角、椎管内占位比较差异无统计学意义(P>0.05).手术后生活质量得分各维度显示,除疼痛评分外,差异均有统计学意义(P<0.05).观察组患者手术时间略高于对照组,并发症均低于对照组,且差异具有统计学意义(P<0.05).根据Frankel脊髓损伤分级,观察组在术前、术后的神经系统恢复情况进行比较,患者脊髓损伤较术前明显缓解(P<0.05),且优于对照组.结论腰椎爆裂骨折患者实施椎板开窗保留脊柱后方复合体术比传统方法有更强的脊柱稳定性,患者预后生活质量明显提高.同时,手术方法对患者损伤小、植入骨量少、手术出血少、神经功能恢复好、经济费用少,尤其对于无明显脊神经损伤或损伤较轻微患者,是一种值得继续探讨与推广的新的首选术式.

目的 研究脊柱术后30 d内再手术率及原因.让术者更好地理解再手术的原因,更好地进行术后应对.方法 统计我院2005-2015年脊柱手术病人3576例,挑选出所有30 d内再次手术病人资料,计算再手术率.对比再手术病人与无再手术病人的病因分类、术前诊断、是否使用内植物、手术部位,分析30 d内再次手术的原因.结果 本研究中所有脊柱病人的30 d内再手术率为1.59%(57/3576).使用内固定物的病人明显高于未使用的病人(2.16%对比0.88%,x2=9.167,P=0.003).术前病因分类为创伤的病人比退变性疾病病人具有更高的再手术率(x2=6.315,P=0.012).手术部位感染、术后血肿形成、内固定螺钉位置异常、减压不充分是主要的再手术原因.术后血肿压迫导致的运动神经元瘫痪是超急性期再手术的主要原因(术后0~1 d);手术部位感染则是亚急性期再次手术的主要原因(术后11~30 d).结论 要预防脊柱术后早期(30 d内)再次手术,临床医护人员要注意防治术后手术部位感染、血肿等,以减轻病人痛苦,提高手术质量.

Objective:To compare the effect of two surgical methods in the treatment of multiple thoracic spinal tuberculosis (MTST).Methods:80 MTST patients in our hospital from February 2012 to July 2015 were enrolled and randomly divided into an observation group and a control group,with 40 cases in each group.Patients in the control group received costotransverse radical debridement and bone graft fusion,while those in the observation group received radical debridement and bone graft fusion combined with internal fixation.The clinical effect and the incidence of complications were compared between the two groups.Results:The total response rate in the observation group was higher than that in the control group,while the recurrence rate was significantly lower (P＜0.05).The duration of chest pain,operation time,bone graft fusion time and hospital days in the observation group were significantly shorter than those in the control group (P＜0.05).The intraoperative blood-loss volume and the incidence of complications in the observation group were lower than those in the control group (P＜0.05).Conclusion:Extrapleural radical debridement and bone graft fusion combined with internal fixation was more effective than costotransverse radical debridement for the treatment of MTST.It could relieve pain and reduce the incidence of complications and recurrence rate.

Objective To study the effect of pre-injection of the mixtures of gelatin sponge and lidocaine in percutaneous vertebroplasty (PVP) on postoperative therapeutic effect and bone cement leakage.Methods Seventy-four patients undergoing PVP were selected and randomly divided into observation group and control group.Patients in observation group were injected with the mixtures of gelatin sponge and lidocaine before the bone cement injection,while those in control group received conventional PVP and was injected with bone cement directly after acupuncture.Results The 3 days to 1 month of follow-up after operation showed that the scores of visual analogue scale in observation group were significantly lower than those in control group (P＜0.05).In 1 year after operation,the Oswestry disability index (ODI) score of observation group was (14.6±5.0),significantly lower than (23.1±4.4) of control group;and the incidences of vertebral refracture in control group and observation group were 3.77％ and 0.00％,respectively.Two cases in observation group appeared type S leakage,while control group had 2 cases of type B leakage,3 cases of type C leakage and 2 cases of type S leakage,with a total leakage rate of 13.2％.Conclusion The pre-injection of mixtures of gelatin sponge and lidocaine can effectively reduce the incidence of bone cement leakage in vertebroplasty and has better efficacy in alleviating patient's pain,worth of popularizing in the clinic.

By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li + ) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/β-catenin pathway in vitro . We also examined the effect of locally administered Li + on defects in rat tibia between CPC and Li/CPC in vivo . Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li + from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/β-catenin pathway in osteoporosis.

This study investigated whether single nucleotide polymorphisms (SNPs) covering the MUC22 region are associated with ankylosing spondylitis (AS) in the young Chinese Guangxi Zhuang population. A case-control study was performed in unrelated young patients with AS (n=154) and sexand ethnicity-matched controls (n=430) from the Guangxi Zhuang ethnic group. All patients met classification criteria of the Assessment of SpondyloArthritis International Society (ASAS) for AS. A TaqMan genotyping assay was used to genotype cases and controls for 12 SNPs covering MUC22. A significant association with AS was observed in 8 SNPs: rs115194949 and rs2517554 were addictive models (AG vs. AA, P=0.858, OR=1.08, 95% CI=0.45-2.60; GG vs. AA, P=1.78×10-29, OR=16.75, 95% CI=6.69-41.96; CT vs. CC, P=0.026, OR=1.67, 95% CI=1.06-2.62; TT vs. CC, P=2.71×10-8, OR=6.87, 95% CI=3.48-13.54). The G allele in rs115194949 and T allele in rs2517554 increased the risk of AS (P=1.65×10-28, OR=5.55, 95% CI=4.10-7.52 and P=1.88×10-8, OR=2.27, 95% CI=1.73-3.00, respectively). Rs2523898, rs4713420, rs12110785, rs4713422 and rs10947121 were also addictive models (GA vs. GG, P=0.039, OR=1.66, 95% CI=1.03-2.68; AA vs. GG, P=7.14×10-12, OR=12.14, 95% CI=5.95-24.79; CT vs. TT, P=0.013, OR=2.11, 95% CI =17-3.79; CT+CC vs. TT, P=0.010, OR=2.12, 95% CI=1.19620-3.75; CG vs. GG, P=0.001, OR=1.96, 95% CI=1.302.95; CC vs. GG, P=1. 40×10-6, OR=6.32, 95% CI=2.99-13.37; CC vs. TT, P=0.002, OR=1.93, 95% CI=1.28-2.91; CC vs. TT, P=1.56×10-6, OR=6.27, 95% CI=2.96-13.25; respectively). The C allele in rs76100089 was strongly associated with AS (P=0.002, OR=2.20, 95% CI=1.34-3.60). Furthermore, two block haplotypes were significantly associated with AS. The pairwise analysis of the rs115194949/rs2517554 alleles found that the A-C, G-T and G-C haplotypes (Reference, OR 5.43, 95% CI 4.04-7.29, P=2.72×10-29 and OR 5.46, 95% CI 4.03-7.40, P=7.25×10-28, respectively) significantly increased the risk of AS. The pairwise analysis of the rs4713422/rs10947121 alleles found that the G-T and C-C haplotypes (Reference and OR 1.52, 95% CI 1.26-1.85, P=1.58×10-5, respectively) also significantly increased the risk of AS in comparison with the C-G and T-A carriers in the pairwise analysis of the rs76100089/rs77387993 alleles. In conclusion, the study results define a novel risk MUC22 gene associated with the early onset of AS. Common variants in MUC22 may contribute to AS susceptibility in the young Chinese Guangxi Zhuang population.

目的：分析后路经椎弓根截骨治疗脊柱畸形的围术期并发症。方法选取广西医科大学第四附属医院2010年2月至2014年2月后路经椎弓根截骨治疗的146例脊柱畸形患者，其中至少出现一种并发症者30例，分析其并发症情况。结果30例患者经6~30个月随访，并发症为：椎弓根螺钉置入椎管、截骨端合拢压迫或牵拉神经、截骨处残留骨块压迫神经、急性脊髓损伤、感染、断钉及脱帽、肠系膜上动脉综合症、交界性后突、切口延迟愈合、螺钉切割、局部呼吸异常、皮下血肿、硬脊膜损伤。结论后路经椎弓根截骨治疗脊柱畸形具有明显效果，但往往伴有神经损伤、出血、硬膜损伤、切口感染、胸腔积液等并发症，神经功能并发症发生率较高。