Objective To compare the clinical and radiological outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-level mild degenerative lumbar spondylolisthesis. Methods A retrospective analysis was conducted on 80 patients with single-level mild degenerative lumbar spondylolisthesis, including 40 patients treated with UBE-TLIF and 40 patients treated with MIS-TLIF. Perioperative parameters, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), modified MacNab scores, fusion rates, trabecular bone remodeling (TBR) at 3 months postoperatively, and multifidus atrophy and fat infiltration rates at 12 months postoperatively were compared between the two groups. Results The UBE-TLIF group demonstrated significantly less intraoperative blood loss and shorter hospital stays, but longer operative times compared with the MIS-TLIF group (all P < 0.01). At 3 days postoperatively, the VAS score for low back pain was significantly lower in the UBE-TLIF group than in the MIS-TLIF group (P < 0.05), whereas no significant differences were observed between groups in VAS, ODI, or modified MacNab scores at other time points (P > 0.05). The UBE-TLIF group showed significantly higher TBR positivity at 3 months and a higher fusion rate at 6 months postoperatively compared with the MIS-TLIF group (P < 0.05), while no significant difference in fusion rate was observed at 12 months. At 12 months postoperatively, the multifidus atrophy rate and fat infiltration rate were both significantly lower in the UBE-TLIF group than in the MIS-TLIF group (P < 0.05). Conclusion Both UBE-TLIF and MIS-TLIF provide satisfactory clinical outcomes in the treatment of single-level mild degenerative lumbar spondylolisthesis. Compared with MIS-TLIF, UBE-TLIF demonstrates certain advantages in early postoperative pain relief, preservation of paraspinal muscles, and early osteointegration during the fusion process.

Bone defect healing failure and osteoporosis pose significant challenges to clinical orthopedics and geriatric medicine, while the structural heterogeneity of natural heparan sulfate (HS) hinders the clarification of the functional role of 6-O-sulfation patterns in osteogenesis and its translational application. To address this gap, we developed a structurally defined 6-O-sulfated heparan sulfate glycopolymer (6-O-HS) via reversible addition-fragmentation chain transfer (RAFT) polymerization and copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) click chemistry, establishing an engineering-based synthesis strategy with controllable molecular weight and uniform structure. In vitro experiments showed that 6-O-HS (5 µg/mL) significantly enhanced alkaline phosphatase (ALP) activity, osteocalcin (OC) expression, and extracellular matrix mineralization in murine bone marrow mesenchymal stem cells (BMSCs), outperforming conventional HS. RNA sequencing and functional validation revealed that 6-O-HS specifically activated the TGF-β/BMP signaling pathway by upregulating the gene and protein levels of BMP receptors (BMPR1A, BMPR1B, BMPR2) without altering BMP-2 ligand expression. In an ovariectomized (OVX) mouse model, 6-O-HS administration significantly improved bone microarchitecture, increased cortical thickness (Ct.Th) and bone volume fraction (BV/TV), and reduced trabecular separation (Tb.Sp). This study presents a reproducible glycopolymer synthesis and application framework, integrating precision chemical engineering, in vitro mechanistic verification, and in vivo efficacy validation. The framework provides a low-cost, scalable engineering tool for targeted regulation of BMSC osteogenic differentiation, offering novel solutions for bone tissue engineering scaffold development and osteoporosis treatment with broad translational potential in regenerative medicine.

To compare the clinical and radiological outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-level mild degenerative lumbar spondylolisthesis. A retrospective analysis was conducted on 80 patients with single-level mild degenerative lumbar spondylolisthesis, including 40 patients treated with UBE-TLIF and 40 patients treated with MIS-TLIF. Perioperative parameters, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), modified MacNab scores, fusion rates, trabecular bone remodeling (TBR) at 3 months postoperatively, and multifidus atrophy and fat infiltration rates at 12 months postoperatively were compared between the two groups. The UBE-TLIF group had significantly less intraoperative blood loss and shorter hospital stays, but longer operative times compared with the MIS-TLIF group (all P < 0.001). At 3 days postoperatively, the VAS score for low back pain was significantly lower in the UBE-TLIF group than in the MIS-TLIF group (2.98 ± 1.12 vs. 3.62 ± 1.27, P = 0.018), whereas no significant differences were observed between groups in VAS scores at the remaining time points or in ODI scores (all P > 0.05). The UBE-TLIF group showed significantly higher TBR positivity at 3 months and a higher fusion rate at 6 months postoperatively compared with the MIS-TLIF group (P < 0.05), while no significant difference in fusion rate was observed at 12 months. At 12 months postoperatively, the multifidus atrophy rate (29.50 ± 7.72

目的 系统评价romosozumab治疗绝经后骨质疏松的有效性及安全性.方法 检索中国知网、万方、维普数据库以及PubMed、Embase、Web of Science和Cochrane Library数据库,搜集有关romosozumab治疗绝经后骨质疏松的随机对照试验(RCT),对照措施为安慰剂或其他抗骨质疏松药物.检索时间均为建库至2021年5月1日,使用Cochrane手册推荐的评估工具进行偏倚风险评估及质量评价.采用Review Manager 5.3软件进行Meta分析.结果 纳入5项RCT研究,研究对象共12 028例,Meta分析结果显示,干预6个月和12个月后,romosozumab组相比于基线的腰椎骨密度百分比变化显著高于对照组(分别为MD= 8.59,95％CI:4.39～12.79,P＜0.000 1;MD =10.53,95％CI:6.72～14.34,P＜0.000 1).干预12个月后,romosozumab组股骨颈和全髋骨密度百分比变化也显著高于对照组(均为P＜0.000 1)o romosozumab组与对照组相比不良事件发生风险显著降低(RR = 0.97,95％CI:0.95～0.99,P=0.01),2组严重不良事件发生风险无显著差异(P=0.89).结论 相比于安慰剂或对照药物,romosozumab升高骨密度效果显著,且总体安全性更高,但结论仍需进一步的证实.

Abstract Background The correlation between smoking and alcohol consumption and the development of Dupuytren’s disease (DD) has been acknowledged. However, the definitive causal relationship between these two factors and DD remains elusive. In order to establish a causal connection, we employed the two-sample Mendelian randomization method to evaluate the relationship between smoking and alcohol consumption and DD. Methods Based on publicly available genome-wide association studies (GWAS), two-sample univariate MR analyses were performed to assess the causal effects of drinks per week, cigarettes per day, smoking initiation, age of initiation, and smoking cessation on DD. We used inverse variance weighted (IVW) to generate the primary results for the MR analysis. Furthermore, we performed sensitivity MR analyses based on various methods to assess the robustness of estimations. Bidirectional MR analyses were used to study the interaction between smoking and alcohol consumption. Multivariate MR analyses were used to obtain independent causal effects of smoking or drinking on DD. Results Our two-sample MR, which was predominately based on IVW, revealed a causal relationship between drinks per week and DD (OR = 2.948, 95%CI: 1.746–4.975, P = 5.16E-05). In addition, there is no causal association between cigarettes per day, smoking initiation, age of initiation, smoking cessation and DD. Similar conclusions were reached by other MR methods. The results of the bidirectional MR analyses showed that the causal relationships between age of initiation and drinks per week were robust and significant. Multivariate MR results indicated that the causal effect of alcohol consumption on DD was independent of smoking. Conclusion Our Mendelian Randomization study indicated that there is a causality between drinking alcohol and DD, but no such causality was found between smoking and DD. This is the first study to prove that drinking alcohol could cause DD. This could help people who are trying to prevent DD from happening in the first place.

目的 评价经皮椎间孔镜下腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)在治疗高位腰椎间盘突出症中的疗效.方法 分析南京医科大学附属无锡人民医院脊柱外科2017年3月至2020年3月收治的23例高位椎间盘突出症(L1～2、L2～3、L3～4)的患者资料,其中男14例,女9例;年龄32～82岁,平均(53.04±13.47)岁;L1～2椎间盘突出症2例,L2～3突出5例,L3～4突出16例.收集术前、术后下地活动时、术后6个月患者疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry 功能障碍指数(oswestry disability index,ODI),对比术前、术后CT下突出髓核组织后缘与椎板矢状径距离以评价患者症状改善情况.改善率使用(术前ODI分值-术后6个月ODI分值)/术前ODI分值X100％表示.结果 术前VAS平均(7.17±0.87)分,ODI指数平均(71.13±4.66)％.术后下地活动时VAS平均(2.22±0.90)分,ODI指数平均(19.65±4.29)％.术后6个月VAS平均(0.57±0.66)分,ODI指数平均(6.09±2.52)％.术前CT下突出髓核组织后缘与椎板矢状径距离为(1.22±0.66)mm,术后为(6.77±0.89)mm.术前的VAS评分、ODI指数与术后下地活动时、术后6个月相比,术前、术后CT下突出髓核组织后缘与椎板矢状径距离相比,差异均有统计学意义(P＜0.05).术后下地活动时,患者症状改善率优8例(34.8％),良15例(65.2％).术后6个月患者症状改善率皆为优(100.0％).结论 PELD作为治疗高位椎间盘突出症的新的手术方式,可直接减压,手术创伤小,不破坏脊柱后方稳定结构,术后能早期下床活动,恢复快,具有满意的临床疗效.

目的:以经皮内镜经椎间孔入路腰椎间盘切除术(PETD)作为对照,探讨经皮内镜经椎板间入路腰椎间盘切除术(PEID)治疗下腰椎椎间盘突出症(LDH)患者的临床应用价值.方法:回顾性分析2018年1月至2021年5月收治的136例下腰椎LDH患者,包括L4/5 LDH患者75例,其中39例采用PETD,36例采用PEID;L5/S1 LDH患者61例,其中36例采用PETD,25例采用PEID.记录并比较患者术中透视次数、手术时间、术后住院时间,及术前和术后1 d、1个月及6个月疼痛视觉模拟量表评分(VAS)、Oswestry功能障碍指数(ODI),以及并发症发生情况.结果:所有患者均顺利完成手术.无论L4/5还是L5/S1 LDH患者,PEID组患者术中透视次数少于PETD组患者,且差异有统计学意义(P<0.001),而两组患者手术时间、术后住院时间差异均无统计学意义(P均>0.05).无论L4/5还是L5/S1 LDH患者,无论采用PEID还是PETD,患者术后1 d、1个月及6个月VAS评分、ODI均低于术前,且差异均有统计学意义(P均<0.05).无论L4/5还是L5/S1 LDH患者,术前、术后1 d、1个月及6个月PEID组与PETD组患者VAS评分、ODI差异均无统计学意义(P均>0.05).PETD组1例患者术后出现椎间隙感染.无一例患者复发.结论:与PETD比较,PEID治疗下腰椎(L4/5,L5/S1)LDH患者同样有效,且术中辐射明显更少.应依据具体情况选择合适的手术入路.

We aimed to investigate the expression level of long noncoding RNA (lncRNA) zinc finger E-box-binding homeobox two antisense RNA 1 (ZEB2-AS1) in osteosarcoma and explore its possible regulatory mechanisms. Expression of lncRNA ZEB2-AS1 was detected by quantitative real-time PCR in 63 cancerous tissues and 25 adjacent normal mucosal tissues from patients with osteosarcoma. The correlation between the lncRNA ZEB2-AS1 level and clinicopathological characteristics of the osteosarcoma patients were evaluated, and 5-year overall survival (5OS) was also analyzed according to lncRNA ZEB2-AS1 expression. The ZEB2-AS1 and miR-145 recombinant expression vector was used to analyze their relationship in an in vitro cell system. Luciferase reporter gene assays and RNA immunoprecipitation assays were used to verify the interaction between ZEB2-AS1 and miR-145. The proliferation, apoptosis and migration of osteosarcoma cells were determined by Cell counting kit-8 assays, Annexin V-PI assays and transwell assays, respectively. A significantly increased level of lncRNA ZEB2-AS1 with a fold change of 3.86 was found in osteosarcoma tissues compared with control tissues (P < 0.001). The Chi-square test revealed that lncRNA ZEB2-AS1 expression in osteosarcoma was significantly different according to radiology classification (P = 0.018), TNM stage (P = 0.000) and survival status (P = 0.005). The 5OS was 18.4% and 52% in osteosarcoma patients with higher and lower lncRNA ZEB2-AS1 expression, respectively. Significantly increased ZEB2-AS1 expression was found in osteosarcoma cells, while decreased levels of miR-145 were confirmed in osteosarcoma tissues and cell lines compared to controls. Moreover, a negative correlation was found between the expression level of ZEB2-AS1 and miR-145 in osteosarcoma tissues (R-2 = 0.71, P < 0.01). ZEB2-AS1 knockdown resulted in decreased osteosarcoma cell proliferation, increased apoptosis and reduced migration. In addition, negative regulation of miR-145 by ZEB2-AS1 in osteosarcoma cells was also observed, and the effects of ZEB2-AS1 on osteosarcoma cells were found to be regulated by miR-145. Significantly upregulated lncRNA ZEB2-AS1 expression in osteosarcoma patients influences the prognosis of patients, and ZEB2-AS1 accelerates tumorigenesis and osteosarcoma development by downregulating miR-145.

Objective:To observe the clinical efficacy, surgical techniques, and complications of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation with single-segment prolapse.Methods:The clinical data of 40 patients (including 22 males and 18 females, aged 18-52 years old, with an average age of 32 years) with single-segment prolapse and free lumbar disc herniation from January 2018 to March 2019 in Wuxi People's Hospital affiliated to Nanjing Medical University were retrospectively analyzed. The diseased segment included L 3/4 (4 cases), L 4/5 (29 cases), and L 5/S 1 (7 cases). According to the Lee classification criteria, the severity of lumbar disc herniation was type Ⅰ in 3 cases, type Ⅱ in 7 cases, type Ⅲ in 21 cases, and type Ⅳ in 9 cases. All 40 patients were treated with PELD, 34 and 6 of which underwent the foraminal approach and interlaminar approach, respectively. The patients' postoperative recovery and complications were observed, and patients' visual analogue scale (VAS) and Oswestry disability index (ODI) were compared before operation and 1 day, 1 month, and 6 months after operation. At 6 months after the operation, the MRI was reviewed to determine whether the nucleus pulposus relapsed. The MacNab standard was used to evaluate the efficacy at 6 months after surgery. Results:The operation was successfully conducted in all patients. The operation time was 45.9-72.0 (59.8±12.5) min. The intraoperative blood loss of all patients was less than 18 mL. One case of intervertebral space infection occurred in a postoperative patient with the foraminal approach, and one patient had residual symptoms after an interlaminar approach. All 40 patients were followed up after surgery. The follow-up time was 6-12 (8.2±2.7) months. The VAS scores were (2.3±0.7), (0.8±0.3), and (0.3±0.1) 1 day, 1 month, and 6 months after surgery, and the ODI was 21.3%±3.4%, 11.9%±2.9%, and 3.1%±1.5%, respectively, which were all lower than the preoperative values (7.2±1.3) and (62.8%±5.5%). The difference was statistically significant ( F=10.812, 8.750, all P values<0.05). MRI was re-examined 6 months after the operation. One patient that underwent the interlaminar approach had residual prolapsed nucleus pulposus, and none of the remaining patients showed residual nucleus pulposus or recurrence. According to the MacNab standard, the curative effect was evaluated at 6 months after operation. Thirty-six cases were rated as excellent, two cases were good, and two cases were fair. The rating of excellent and good curative effect was 95.0%. Conclusions:PELD has satisfactory clinical effects in the treatment of single-segment prolapsed lumbar intervertebral disc herniation; however, treating patients with high prolapse and tail displacement is still challenging for surgeons.

Objective The aim of this study was to compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) in treating L5/S1 disc herniation. Methods A retrospective analysis of 76 patients with L5/S1 intervertebral disc herniation was performed. There were two surgical treatment groups: one with patients receiving PEID and the other with patients receiving PETD. The two groups were compared by length of surgery, times of intraoperative X‐ray exposure, postoperative time in bed, length of hospital stay, operative complications, patient's assessment of pain using a visual analogue scale (VAS), and disability using the Oswestry disability index (ODI) before and after surgery. Results Subjects in the PEID group were in surgery for 60.90 ± 13.11 min and needed intraoperative X‐ray exposure 4.10 ± 1.09 times. Patients in this group were ambulatory by 7.52 ± 1.08 h after surgery and were hospitalized for 5.05 ± 0.92 days. In contrast, patients in the PETD group were in surgery for 84.06 ± 15.58 min and needed intraoperative X ray exposure 12.81 ± 8.46 times. These patients were ambulatory by 7.06 ± 0.91 h after surgery and remained in the hospital for 4.94 ± 0.80 days. Based on these data, operation time and fluoroscopy time were significantly less (P < 0.002 and P < 0.001, respectively) for subjects in the PEID group. However, ambulatory time and hospitalization were similar for both in terms of pain relief and decreased disability, and subjects in both groups responded well to the surgery and showed a significant decrease in both VAS and ODI scores at their 1‐year follow‐up (P < 0.01). Furthermore, there were no statistically significant differences between the two surgeries in terms of pain relief and decrease in disability. Conclusion For L5/S1 disc herniation, PEID and PETD provide similar results for patients. However, PEID has the advantage over PETD in that it is a shorter procedure and exposes the patient to less radiation. Keywords

Owing to high specific strength, biocompatibility, and corrosion resistance, titanium (Ti) and its alloys are considered the best materials for bone repair and replacement. However, Ti-based metals have low surface bioactivity and low bond strength with bone tissues, restricting their clinical application. Therefore, surface modification of Ti-based implants is important for improving surface bioactivity and biocompatibility. In this study, we prepared a ceramic coating containing calcium (Ca) and phosphorus (P) on Ti by plasma electrolytic oxidation (PEO). The coating was characterized by scanning electron microscopy, energy dispersive X-ray spectroscopy, and atomic force microscopy to study its surface morphology, Ca and P contents, and surface topography. The hydrophilicity of the coating was evaluated by measuring the static contact angle. Nanoindentation testing was performed to determine the microelastic modulus and microhardness. Characterization revealed the formation of a coating that was dense inside but porous and rough outside by PEO on the Ti surface. The coating consisted of Ti, Ca, P, and O. The microelastic modulus and microhardness of the coating were (39.08+8.23) GPa and (2.36 +/- 0.85) GPa. To conclude, PEO formed a loose and porous TiO2 coating containing Ca and P on the Ti surface, which exhibited good bioactivity and mechanical performance and has application potential.

Objective: The study seeks provide a comparison between percutaneous compression plate (PCCP) fixation and dynamic hip screw (DHS) fixation for the purpose of treating fractures of the osteoporotic intertrochanteric femoral bone. Methods: Thirty-six senior patients with intertrochanteric fractures were gathered as participants for the present research, distributed under the PCCP (n = 30) group or DHS (n = 22) group between July 2011 and December 2013. Operation time, incision length, blood loss, time to fracture union, and serum hemoglobin (Hb), and albumin (Alb) levels were compared between groups. The hip scoring system used to evaluate the results was that of the Harris system. Results: A follow-through was made for all patients for the average span of 12 months with an actual range of 6 to 18 months. Compared with the DHS group, the PCCP group had shorter operative times, smaller incision lengths, and less blood loss (P < 0.05). The study noted no significant differences between groups in terms of fracture healing time or serum Hb and Alb levels. Conclusion: PCCP fixation results in superior clinical outcomes compared with DHS fixation for the stable intertrochanteric fracture treatment in elderly patients.

目的 探讨不同斜坡椎管角对C 0～C3颈椎-钉棒固定系统拔出力的影响.方法 选择1例成年健康男性,重建上颈椎C 0～C3三维模型及上颈椎-钉棒系统有限元模型,提取各节段自由度,运算并获得各解剖结构的应力应变等数据,尤其是不同的斜坡椎管角条件下,固定螺钉的结构应力.结果 C 0～C 1、C 1～C2、C 2～C3各节段自由度相对于正常模型分别下降21.50％、42.03％、38.50％.C 1置入螺钉最大米塞斯(Mises)应力为303 MPa,C 2置入螺钉最大Mises应力为263 MPa,C 3置入螺钉最大Mises应力为233 MPa,C 1～C3螺钉Mises应力呈现递减趋势.在不同斜坡椎管角工况载荷条件下,C 1～C3螺钉监测点的拔出力,跟随斜坡椎管角增大趋势,螺钉拔出力呈现增长趋势.结论 上颈椎椎弓根螺钉内固定有限元模型具有精确的几何外形,能够准确模拟实际临床力学环境,从而为临床枕颈融合固定提供良好的术前指导.

OBJECTIVE:To explore whether Ipriflavone could prevent postmenopausal osteoporosis (PMOP) and improve bone quality via promoting osteogenesis of bone marrow-derived mesenchymal stem cell (MSCs). MATERIALS AND METHODS:MSCs were extracted from rats and identified using flow cytometry. Osteogenic specific genes and adipogenic specific genes in MSCs were detected by quantitative Real-time polymerase chain reaction (qRT-PCR). The effect of Ipriflavone on osteogenesis was detected by CCK-8 (cell counting kit-8) assay, ALP activity detection, alizarin red staining and Western blot, respectively. Furthermore, ovariectomized PMOP rat model was constructed. The effects of Ipriflavone on osteogenesis, BMD and bone biomechanical properties of ovariectomized rats were detected. RESULTS:MSCs derived from ovariectomized rats exerted multiple differentiation potentials. CCK-8 assay indicated that 0.8 μM Ipriflavone were the maximal dose that did not affect MSCs proliferation, which was selected for the following experiments. In vitro researches demonstrated that Ipriflavone remarkably promoted MSCs osteogenesis. In vivo results indicated that BMD, BV/TV, Tb.N and Tb.Th were decreased in ovariectomized rats than those of rats in sham group. Ipriflavone treatment remarkably prevented osteoporosis via promoting MSCs osteogenesis in ovariectomized rats. CONCLUSIONS:Ipriflavone prevents postmenopausal osteoporosis, improves bone quality and protects bone tissue via promoting MSCs osteogenesis.

目的 观察重组人甲状旁腺素 1-34 ( recombinant human parathyroid hormone 1-34 )应用于绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)患者的临床疗效.方法 筛选出68例绝经后骨质疏松症患者,所有患者入组后均口服元素钙500 mg/d和维生素D 200 U/d,连续服用26周后加用皮下注射重组人甲状旁腺素1-34(特立帕肽)20 μg /d,再连续治疗26周,于应用特立帕肽治疗前及治疗后的13 和26 周测定腰椎(L1-4)和股骨近端骨密度(BMD),采静脉血测定血清骨钙素(OC)、碱性磷酸酶(AKP)水平,应用疼痛视觉模拟评分法(VAS 评分)评价患者的疼痛程度,并记录不良反应情况.结果 68位患者均完成全疗程治疗.应用特立帕肽治疗13周时,腰椎L1-4、股骨颈、大粗隆和股骨干骨密度改善不明显( P＞0. 05),血清骨钙素和碱性磷酸酶较治疗前升高(P＜0. 05),疼痛缓解明显(P＜0. 05);治疗26周时,腰椎L1-4和股骨颈骨密度较治疗前明显增高(P ＜0. 05),而大粗隆和股骨干骨密度改善不明显(P＞0. 05),血清骨钙素和碱性磷酸酶呈持续升高趋势(P＜0. 05),疼痛明显减轻(P＜0. 05).治疗期间不良反应的情况均较轻微,没有给予特殊处理即自行缓解.结论 连续26周使用重组人甲状旁腺素1-34能有效地促进患者骨形成,缓解骨质疏松症患者疼痛症状,提高患者腰椎、股骨骨密度.

Objective To compare clinical result of minimally invasive transforaminal lumbar interbody fusion(TLIF) and open TLIF through Wiltse approach and conventional approach in treatment of degenerative lumbar disease. Methods Thirty-six and 46 patients of Wuxi People′s Hospital who underwent minimally invasive TLIF ( MIS-TLIF) through Wiltse approach and TLIF through conventional approach separately were selected. The operating time, blood loss, creatine kinase, the leaving bed time, postoperative complications, and intervertebral fusion rate were recorded. The function of lumbar and legs was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI). The operating time, blood loss, creatine kinase, the leaving bed time, postoperative complications, intervertebral fusion rate were compared between MIS-TLIF group and TLIF group. VAS and ODI were compared between MIS-TLIF group and TLIF group pre- and post-operatively. Results The operating time, blood loss, postoperative creatine kinase (3 days), the leaving bed time in the MIS-TLIF group were significantly less than those in the group of TLIF( all P values < 0. 01) . The rate of complication and intervertebral fusion at 1 year between two groups wasn′t significantly different ( all P values > 0. 05). VAS and ODI of 1 year were significantly lower than preoperative in both groups ( all P values < 0. 01 ), however, there were no significant differences neither at preoperative or final follow-up between groups ( all P values > 0. 05). Conclusions MIS-TLIF is an effective way to treat degenerative lumbar disease. It can reduce the operation wound, hemorrhage during operation and promote early rehabilitation of patients.

Objective To investigate the feasibility and early curative effect of minimally invasive transforaminal lum-bar interbody fusion ( MIS-TLIF) in the treatment of low lumbar degenerative disease. Methods A total of 30 pa-tients underwent MIS-TLIF for low lumbar degenerative disease. They contained 12 cases ofⅠ~Ⅱdegree spondylo-listhesis,8 cases of degenerative lumbar spinal stenosis with segmental instability and 10 cases of protrusion of lumbar intervertebral disc. All the patients underwent one-level fusion by the same surgeon. Results The surgical time, in-traoperative blood loss volume, X-ray exposed time and the first leaving bed time after surgery were 127~209(168 ± 41) min, 23~361(192 ± 169) ml, 72~136(104 ± 32) s,1. 4~3. 8(2. 6 ± 1. 2) d. VAS of the preoperative and the last follow-up were (7. 20 ± 1. 02)points and (1. 71 ± 0. 66)points,the difference had statistical significance(P<0. 01). The rates of fusion and complication incidence were 100% and 0% at the last follow-up. The X-ray film showed that the cage in intervertebral space was in good position and pedicle screws had not any displacement or snap. Conclusions MIS-TLIF is appropriate for Ⅰ~Ⅱ degree spondylolisthesis, degenerative lumbar spinal steno-sis and protrusion of lumbar intervertebral disc and has an advantage of less blood loss and trauma. But it takes more time to finish the operation and X-ray exposing time is more.

Lumbar degenerative disease is the major cause of low back pain. Currently, surgical treatment remains the standard care for lumbar degenerative disease. This study aimed to evaluate the efficacy and complications of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of single-segment lumbar degenerative disease. A total of 75 patients with single-segment lumbar degenerative disease that underwent MIS-TLIF from 2011 to 2014 in Wuxi People’s Hospital were enrolled, while 120 cases undergoing open transforaminal lumbar interbody fusion (O-TLIF) during the study period were randomly sampled as controls. The duration of surgery, intraoperative blood loss, duration of intraoperative X-ray scan, creatine kinase level, time to first post-surgical ambulation, incidence of post-surgical complications, rate of interbody fusion, Visual Analogue Scale (VAS) score and Oswestry disability index (ODI) were compared between MIS-TLIF and O-TLIF groups. The mean intraoperative blood loss, time to first post-surgical ambulation and serum creatine kinase level were significantly lower in MIS-TLIF group than in O-TLIF group (P 0.05). VAS score and ODI significantly reduced one year post-surgery compared to those before surgery in both groups (P<0.05). In conclusion, MIS-TLIF is an effective treatment for lumbar degenerative disease, which alleviates surgical invasiveness, reduces intraoperative blood loss, and accelerates recovery.

目的：比较微创与开放经椎间孔入路腰椎椎体间融合术治疗腰椎退行性疾病的疗效。方法选取腰椎退行性疾病患者52例，分为微创经椎间孔椎体间融合治疗20例（微创组）和开放经椎间孔椎体间融合治疗32例（对照组）；比较两组手术时间、术中出血量、术中射线照射时间、肌酸激酶（CK）浓度、术后下床活动时间及椎间融合率；比较两组术前及末次随访VAS评分及Oswestry功能障碍指数（ODI ）。结果两组患者均获随访12‐24个月。微创组术中出血量较对照组少（P＜0．05）；术后首次下床活动较对照组早（P＜0．05）；术后末次随访时，两组 VAS评分、ODI均较术前降低，但两组间差异无统计学意义（ P＞0．05）。微创组术后3 d血清 CK 浓度低于对照组（ P＜0．05）。两组患者椎间融合率均为100％。结论微创经椎间孔入路腰椎椎体间融合术治疗腰椎退行性疾病临床效果好，能减少手术创伤，降低术中出血量，促进患者早期康复。