Intervertebral disc degeneration (IVDD) is one of the main causes of spinal diseases and chronic low back pain. Nucleus pulposus (NP) cells are in a hypoxic environment, and their functions may be regulated by the hypoxia-inducible factor (HIF) family. In recent years, ferroptosis has been confirmed to be closely related to IVDD. HIF-2α plays a key role in hypoxic response, but its mechanism of regulating ferroptosis in IVDD remains unclear. This study aims to explore whether HIF-2α promotes ferroptosis of NP cells by activating the IL-6/hepcidin pathway and inhibiting the expression of iron transporter FPN1. Primary nucleus pulposus cells from rats were cultured under normoxic and hypoxic conditions, with RSL3 and TBHP used as ferroptosis inducers. Cell viability was detected by CCK-8 assay. The expressions of HIF-2α, IL-6 and hepcidin were regulated by siRNA and overexpression plasmids. Gene and protein expressions and their interaction were analyzed by RT-qPCR, Western blot, Co-IP and immunofluorescence. A rat tail vertebra needling-induced IVDD model was established, and MRI assessment, histological staining and biochemical index detection were performed. Hypoxia significantly increased the sensitivity of NP cells to RSL3 and TBHP at 6, 12, and 24 h, and upregulated HIF-2α expression at both mRNA and protein levels. HIF-2α overexpression promoted IL-6 transcription and hepcidin expression, while HIF-2α knockdown blocked hypoxia-induced upregulation of IL-6 and hepcidin. Dual-luciferase reporter assay confirmed that HIF-2α directly activated the IL-6 promoter. Co-IP demonstrated direct binding between hepcidin-25 and FPN1. HIF-2α overexpression increased cell death, lipid ROS, Fe²⁺, MDA and 4-HNE levels, and induced mitochondrial shrinkage characteristic of ferroptosis; these effects were reversed by knockdown of IL-6 or hepcidin. In the rat IVDD model, MRI showed that the Sham group had Grade I-II degeneration, while the IVDD group and IVDD+adenovirus vector group exhibited severe degeneration (Grade III-IV). HIF-2α knockdown significantly alleviated degeneration to Grade II-III. HE staining revealed that HIF-2α knockdown reduced NP tissue damage. HIF-2α knockdown also decreased lipid ROS levels, restored FPN1 and GPX4 protein expression, and reduced hepcidin-25, HIF-2α and IL-6 expression in NP tissues. Immunohistochemistry confirmed that HIF-2α knockdown partially restored FPN1 positive expression and reduced HIF-2α, IL-6 and hepcidin signals. HIF-2α in IVDD promotes ferroptosis by activating the IL-6/hepcidin signaling pathway, inhibiting FPN1 expression, and thereby exacerbating intervertebral disc degeneration. Targeting this pathway may offer a new therapeutic strategy for IVDD.

Objective: This study aims to compare the incidence of deep vein thrombosis (DVT) between patients undergoing Posterior Lumbar Interbody Fusion（PLIF）and percutaneous endoscopic lumbar interbody fusion (PELIF) , identify independent risk factors, and develop a predictive model for postoperative DVT risk. Methods: This retrospective study included 207 patients who underwent PLIF and PELIF at our hospital from April 2024 to June 2025. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for postoperative DVT. A predictive model was constructed based on these factors, and its discriminative ability was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). Results: The incidence of DVT was significantly higher in the PELIF group compared to the PLIF group (P < 0.001). Univariate analysis revealed that age, intraoperative fluid administration, monocyte percentage, and D-dimer levels were significantly associated with postoperative DVT (P < 0.05). Multivariate logistic regression analysis further confirmed that age, intraoperative fluid administration, and monocyte percentage were independent risk factors. The predictive model constructed based on these factors had an AUC of 0.89 (95% CI: 0.82 - 0.95), indicating good discriminative ability. Conclusion: This study successfully identified independent risk factors for postoperative DVT in lumbar surgery patients and developed a predictive model with high discriminative ability. This model can serve as a practical tool for clinicians to assess postoperative DVT risk, optimize perioperative management, and reduce the incidence of DVT. Registry : Ethics Committee of Shanxi Bethune Hospital, Approval notice number: YXLL-2025-094, Registration date: 1st April 2025.

Background Percutaneous endoscopic lumbar interbody fusion was a new technique that leads to improved visualization, improved safety and less trauma than does the traditional procedure. The purpose of this study was to introduce the technique of percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) and determine its efficacy.Methods 35 patients with an average age of 52.3±13.7 years were treated with single-segment PE-PLIF. The perioperative parameters and the radiographic parameters were measured. The visual analog scale (VAS) score for low back pain, VAS score for leg pain and Oswestry disability index (ODI) score were used to assess the levels of pain and function.Results The mean estimated volume of blood loss was 68.6±32.3 ml, operative time was 179.6±31.0 minutes. PE-PLIF significantly reduced the VAS score for low back pain, VAS score for leg pain and ODI score, and improved the posterior disc height, lumbar lordosis angle and segmental lordosis angle (p < 0.05). The rate of satisfaction was 94.3%. One patient suffered a dural tear. There was one case of contralateral radiculopathy that was relieved after conservative treatment.Conclusions This research suggests that PE-PLIF is a minimally invasive, safe, and effective treatment for degenerative lumbar diseases requiring interbody fusion.

目的 探讨经皮内镜腰椎后路椎间融合术(percutaneous endoscopic posterior lumbar interbody fusion,PE-PLIF)治疗腰椎滑脱症的效果.方法 回顾性分析2019 年1 月～2020 年 10 月单节段MeyerdingⅠ度或Ⅱ度腰椎滑脱症 142 例资料,其中PE-PLIF(内镜组)72 例,开放PLIF(开放组)70 例.2 组一般资料无统计学差异(P＞0.05),随访2 年以上.比较2 组围手术期指标、疗效评价指标和影像学数据.结果 与开放组相比,内镜组术中出血少[(88.6±30.8)ml vs.(543.8±287.6)ml,t =-13.352,P =0.000].2 组术后各时点腰痛及腿痛视觉模拟评分(Visual Analogue Scale,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)较术前均明显改善(P＜0.05),内镜组术后 1 年、2 年腰痛VAS评分低于开放组(P＜0.05),术后1 周内、1 个月ODI低于开放组(P＜0.05),其余各时点组间差异无统计学意义(P＞0.05).术后椎间隙高度、骨盆倾斜角等影像学指标均明显改善(P＜0.05),组间差异无统计学意义(P＞0.05).2 组融合率[93.1%(67/72)vs.94.3%(66/70),x2 =0.000,P =1.000]和融合器沉降率[19.4%(14/72)vs.21.4%(15/70),x2 =0.086,P =0.769]差异无统计学意义.结论 对于Ⅰ、Ⅱ度腰椎滑脱症,相比于开放PLIF,经皮内镜PLIF可以减少术中出血,减轻腰背痛程度,加快术后康复.

Harms和Rolinger[1]于1982年在后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)的基础上改良并首次提出经椎间孔腰椎椎体间融合术(transforaminal lumbar interbody fusion,TLIF).TLIF术通过切除关节突和部分椎板建立工作通路,进行椎管减压、椎间融合,相比PLIF术能保留腰椎后方的韧带、肌肉等组织,且疗效对比PLIF术并无明显不足[2].2003年,Foley等[3]首次提出微创经椎间孔腰椎椎体间融合术(minimally invasive surgery-transforaminal lumbar interbody fusion,MIS-TLIF),基于软组织扩张建立工作通道,进一步减少了对于椎旁软组织的破坏,减少术中出血,降低并发症发生率[1,3-4].但是由于通道狭长,手术视野受限,需要较长时间的学习和练习以确保手术安全[5].相较于其他的微创腰椎椎间融合术,MIS-TLIF术并无明显差距[6-7],在临床上得到了广泛应用并获得满意的临床疗效.

Sensitive detection of procalcitonin (PCT) in serum is crucial for the timely diagnosis and treatment of rheumatoid arthritis. In this work, an electrochemiluminescence (ECL) detection platform is developed based on in-situ growth of Au nanoparticles (AuNPs) in nanochannels and an analyte-gated detection signal, which can realize ECL determination of PCT with high sensitivity. Vertically ordered mesoporous silica films with amine groups and uniform nanochannel array (NH2-VMSF) is easily grown on the supporting indium tin oxide (ITO) electrode through electrochemical assisted self-assembly method (EASA). Anchored by the amino groups, AuNPs were grown in-situ within the nanochannels to catalyze the generation of reactive oxygen species (ROS) and amplify the ECL signal of luminol. An immuno-recognitive interface is constructed on the outer surface of NH2-VMSF, through covalent immobilization of PCT antibodies. In the presence of PCT, the immunocomplex will hinder the diffusion of luminol and co-reactants, leading to a gating effect and decreased ECL signals. Based on this principle, the immunosensor can detect PCT in the range from 10 pg/mL to 100 ng mL-1 with a limit of detection (LOD) of 7 pg mL-1. The constructed immunosensor can also be used for detecting PCT in serum. The constructed sensor has advantages of simple fabrication and sensitive detection, demonstrating great potential in real sample analysis.

Central nervous injury and regeneration repair have always been a hot and difficult scientific questions in neuroscience, such as spinal cord injury (SCI) caused by a traffic accident, fall injury, and war. After SCI, astrocytes further migrate to the injured area and form dense glial scar through proliferation, which not only limits the infiltration of inflammatory cells but also affects axon regeneration. We aim to explore the effect and underlying mechanism of miR-155-5p overexpression promoted astrocyte activation and glial scarring in an SCI model. MiR-155-5p mimic (50 or 100 nm) was used to transfect CTX-TNA2 rat brain primary astrocyte cell line. MiR-155-5p antagonist and miR-155-5p agomir were performed to treat SCI rats. MiR-155-5p mimic dose-dependently promoted astrocyte proliferation, and inhibited cell apoptosis. MiR-155-5p overexpression inhibited nuclear PTEN expression by targeting Nedd4 family interacting protein 1 (Ndfip1). Ndfip1 overexpression reversed astrocyte activation which was induced by miR-155-5p mimic. Meanwhile, Ndfip1 overexpression abolished the inhibition effect of miR-155-5p mimic on PTEN nuclear translocation. In vivo, miR-155-5p silencing improved SCI rat locomotor function and promoted astrocyte activation and glial scar formation. And miR-155-5p overexpression showed the opposite results. MiR-155-5p aggravated astrocyte activation and glial scarring in a SCI model by targeting Ndfip1 expression and inhibiting PTEN nuclear translocation. These findings have ramifications for the development of miRNAs as SCI therapeutics.

Ultrasensitive and selective determination of biomarkers of the bone metabolism in serum is crucial for early screening, timely treatment, and monitoring of the curative effect of osteoporosis, which is a silent disease with serious health threats. Immunoassay with a simple sensing interface and ultrahigh sensitivity is highly desirable. Herein, a simple electrochemical immunosensor is demonstrated based on gold nanoparticles (AuNPs) electrodeposited on chitosan-reduced graphene oxide (CS-G) composite modified electrode, which can achieve sensitive determination of the important biomarker of bone metabolism, bone gamma-carboxyglutamate protein (BGP). To overcome the agglomeration of graphene and introduce a biocompatible matrix with functional amino groups, CS-G is prepared and modified on the supporting glassy carbon electrode (GCE). Then, AuNPs are electrodeposited on CS-G through their interaction between amine groups of CS. The immobilized AuNPs provide numerous binding sites to immobilize anti-BGP antibodies (AbBGP). The specific recognition between BGP and AbBGP results in a reduction in the mass transfer of the electrochemical probe (Fe(CN)6 3-/4-) in solution, leading to a reduced electrochemical signal. Based on this mechanism, fast and ultrasensitive electrochemical detection of BGP is achieved when the concentration of BGP ranges from 100 ag ml−1 to 10 μg mL−1 with a limit of detection (LOD) of 20 ag ml−1 (S/N = 3). The determination of BGP in human serum is also realized with high reliability.

Background:Endoscopic lumbar interbody fusion is a new technology that is mostly used for single-segment and unilateral lumbar spine surgery. The purpose of this study is to introduce percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) with unilateral laminotomy for bilateral decompression (ULBD) for lumbar spondylolisthesis and evaluate the efficacy by comparing it with open posterior lumbar interbody fusion (PLIF). Methods:Twenty-eight patients were enrolled in PE-PLIF with the ULBD group and the open PLIF group. The perioperative data of the two groups were compared to evaluate the safety of PE-PLIF with ULBD. The visual analog scale (VAS) back pain, VAS leg pain, and Oswestry Disability Index (ODI) scores of the two groups preoperatively and postoperatively were compared to evaluate clinical efficacy. Preoperative and postoperative imaging data were collected to evaluate the effectiveness of the operation. Results:No differences in baseline data were found between the two groups (p > 0.05). The operation time in PE-PLIF with the ULBD group (221.2 ± 32.9 min) was significantly longer than that in the PLIF group (138.4 ± 25.7 min) (p < 0.05), and the estimated blood loss and postoperative hospitalization were lower than those of the PLIF group (p < 0.05). The postoperative VAS and ODI scores were significantly improved in both groups (p < 0.05), but the postoperative VAS back pain score in the PE-PLIF group was significantly lower than that in the PLIF group (p < 0.05). The excellent and good rates in both groups were 96.4% according to MacNab's criteria. The disc height and cross-sectional area of the spinal canal were significantly improved in the two groups after surgery (p < 0.05), with no difference between the groups (p > 0.05). The fusion rates in PE-PLIF with the ULBD group and the PLIF group were 89.3% and 92.9% (p > 0.05), respectively, the cage subsidence rates were 14.3% and 17.9% (p > 0.05), respectively, and the lumbar spondylolisthesis reduction rates were 92.72 ± 6.39% and 93.54 ± 5.21%, respectively (p > 0.05). Conclusion:The results from this study indicate that ULBD can be successfully performed during PE-PLIF, and the combined procedure is a safe and reliable treatment method for lumbar spondylolisthesis.

Abstract Purpose: To investigate the effect of percutaneous endoscopic lumbar decompression and fusion (PE-PLIF) for L4/5 lumbar spondylolisthesis. Methods: From September 2019 to June 2020, six patients (two men, four women) with l4/5 lumbar spondylolisthesis from the Department of Orthopedics, Bethune Hospital of Shanxi Province were treated with PE-PLIF. Their ages ranged from 43 to 77 years, with an average of (59.66±17.33) years. The duration of operation, blood loss, blood transfusion, and complications were recorded. Results were evaluated by visual analogue scale (VAS) and Oswestry Disability Index (ODI). Student's t- test was used to compare the parameters before and after operation. Results: Six patients were followed up for an average of 13 months (6~20 months), and their symptoms were significantly improved. VAS scores of low back pain and leg pain at three days (2.19±0.49, 1.47±0.63, respectively) and 24 months (0.41±0.54, 0.24±0.27, respectively) were significantly improved compared with preoperative scores (7.83 ±1.17, 6.50±0.80, respectively). The differences were statistically significant ( t =18.717, 6.771, 17.511, 8.021, all P < 0.001). The ODI score at the last follow-up was also significantly lower than that before surgery (53% ±9% vs 17%±7%, P < 0.001). During the follow-up period, screw extraction occurred in only one patient, and no obvious complications occurred in the other five patients. No complications occurred. Conclusion: PE-PLIF can achieve satisfactory short-term efficacy in the treatment of single-level lumbar spondylolisthesis with a low complication rate and quick postoperative recovery. It is a safe and effective way to treat single-level lumbar spondylolisthesis.

BACKGROUND:Endoscopic lumbar interbody fusion has become an emerging technique. Some researchers have reported the technique of percutaneous endoscopic transforaminal lumbar interbody fusion. We propose percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) as an alternative approach. The purpose of this study was to assess the clinical efficacy of PE-PLIF by comparing percutaneous endoscopic and open posterior lumbar interbody fusion (PLIF).METHODS:Thirty patients were enrolled in each group. Demographic data, perioperative data, and radiological parameters were collected prospectively. The clinical outcomes were evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI) scores.RESULTS:The background data were comparable between the two groups. The mean operation time was longer in the PE-PLIF group. The PE-PLIF group showed benefits in less blood loss and shorter hospital stay. VAS and ODI scores significantly improved in both groups. However, the VAS score of low-back pain was lower in the PE-PLIF group. The satisfaction rate was 96.7% in both groups. The radiological outcomes were similar in both groups. In the PE-PLIF group, the fusion rate was 93.3%, and the cage subsidence rate was 6.7%; in the open PLIF group, the fusion and cage subsidence rates were 96.7% and 16.7%. There were minor complications in one patient in the PE-PLIF group and two in the open PLIF group.CONCLUSIONS:The current study revealed that PE-PLIF is safe and effective compared with open PLIF. In addition, this minimally invasive technique may enhance postoperative recovery by reducing tissue damage and blood loss.

OBJECTIVE:To compare clinical efficacy and safety of endoscopic lumbar interbody fusion (Endo-LIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in treatment of lumbar degenerative diseases.METHODS:A literature search was performed using PubMed, Embase, Web of Science, and Cochrane Library databases. Studies published up to November 15, 2020, that compared Endo-LIF with MIS-TLIF for treating lumbar degenerative diseases were retrieved. Data were extracted according to predefined clinical outcome measures. Primary outcomes were preoperative and postoperative visual analog scale for leg and back pain and Oswestry Disability Index scores. Secondary outcomes were operative time and intraoperative blood loss; length of hospitalization; and complication, reoperation, and fusion rates. Data analysis was conducted with statistical software.RESULTS:The meta-analysis included 6 studies comprising 480 patients. Results of the merged analysis revealed similar complication, reoperation, and fusion rates and preoperative and postoperative visual analog scale for leg and back pain and Oswestry Disability Index scores (P > 0.05) for Endo-LIF and MIS-TLIF. Nevertheless, with the exception of longer operative time (P < 0.05), Endo-LIF compared favorably with MIS-TLIF, with less intraoperative blood loss, shorter hospital stay (P < 0.05), and better long-term functional outcome.CONCLUSIONS:Based on the evidence provided by this study, there is no significant difference in clinical efficacy and safety between Endo-LIF and MIS-TLIF in the treatment of lumbar degenerative diseases. Although Endo-LIF has a longer operative time, it has the advantages of less tissue trauma and rapid recovery after operation.

Abstract Background: Endoscopic lumbar interbody fusion is based on endoscopic lumbar discectomy, a well-established and widely used clinical procedure. Endoscopic lumbar interbody fusion has several key advantages over other types of procedures, including that it is minimally invasive, more precise, safer, and provides better visualization. Most surgeons use the transforaminal approach for this surgery. Here, we report the first percutaneous endoscopic posterior lumbar interbody fusion (PEPLIF). Methods: The authors introduce the PEPLIF technique with step by step instructions and describe key procedures in detail. Tips for controlling hemorrhages and avoiding complications during the procedure are presented. The authors also discuss the indications and advantages of applying the PEPLIF technique.Results: PEPLIF is a repeatable lumbar fusion technique.Conclusions: PEPLIF is a feasible and effective technique for the fusion of L4-5 and L5-S1 (especially L5-S1). All procedures are completed in full using endoscopy without replacing the cannula. The endoscopic view is similar to that of an open posterior lumbar interbody fusion, thus reducing the learning curve.

脑脊液漏(cerebro spinal fluid leakage,CSFL)是脊柱手术比较常见的并发症.术后脑脊液漏修补或翻修手术增加了感染的风险. 在临床中,一种意见认为引流管应留置较长时间(8～12 d)[1]. 另一种意见是引流管留置较短时间(3～5 d)[2,3].目前多数学者认为延长引流时间并间断夹闭引流管是治疗脊柱手术后脑脊液漏的有效方法,相对于常规术后3d拔除切口引流管并更换切口敷料方法的效果更好、 并发症较少.但是研究方法多为比较近期伤口愈合情况等,未查阅到关于远期患者疗效的对照研究. 本研究通过对不同拔管时间的2组患者进行1年以上随访,对不同拔管时间治疗腰椎术后脑脊液漏的远期疗效进行研究.

Objective To evaluate the clinical efficacy and complications in the intraoperative use of PKP in the treatment of osteoporotic thoracolumbar vertebral compression fractures.Methods From January 2014 to June 2015, forty-two patients with osteoporotic thoracolumbar vertebral compression fractures treated by PKP were analyzed retrospectively.The VAS was evaluated preoperatively ,1 day after operation and during 6-month follow-up respectively.All patients' vertebra height was recorded before and after operation.Results They were followed up after the operation.All of 46 patients were available for a mean follow-up of 9.3 months (range 3-18 months).The average length of stay was 5.5 d (range 5-7 days).At final follow-up, mean VAS was 2.2±1.5, significantly lower than that of the preoperative (7.2±2.3)(P<0.01).The height of fractured vertebra at 1 day after operation was significantly higher than that before operation (P<0.05).Conclusion The therapeutic effect of PKP for the treatment of osteoporotic thoracolumbar vertebral compression fractures is better, which can effectively alleviate the pain, and effectively improve the function.Thus, it is an alternative operation for the treatment of osteoporotic thoracolumbar vertebral compression fractures, which is worth popularizing.

自1994年Abumi等[1]和Jeanneret等[2]分别报道颈椎后路椎弓根螺钉(posterior cervical pedicle screw,PCPS)内固定技术以来,PCPS以其三柱固定的优势,在复杂颈椎疾病的手术治疗中取得较大成功[3,4],已广泛应用于临床. 对于单纯颈前钛板螺钉内固定无法提供足够稳定性的情况下,需联合后路侧块螺钉或者椎弓根螺钉辅助内固定, 手术时间延长、手术创伤增加.Aramomi等[5]于2004年首次提出颈椎前路反向椎弓根螺钉技术,并于2008年初步应用于临床. Koller等[6]提出下颈椎前路椎弓根螺钉 (cervical anterior transpedicular screw,CATPS)内固定技术.CATPS内固定技术可一期完成前路手术的同时获得更好的内固定稳定性, 简化手术步骤、降低手术创伤、减少手术时间,引起临床医生的关注.国内也有学者对下颈椎前路椎弓根钉技术进行研究,并有部分学者设计钢板并应用于临床[7]. 目前无学者对模拟置钉时的可变范围或安全置钉范围进行详细研究.本文重点对下颈椎前路椎弓根钉的安全置钉范围进行研究.

Objective To investigate the clinical effect of proximal fibula osteotomy in the treatment of knee osteoarthritis. Methods Between January 2015 and June 2016, 46 patients with knee osteoarthritis, who were treated with proximal fibula osteotomy, were included in the study. All patients were female, aged 47-68 years old, with an average of (63±3) years old. The visual analog scale (VAS) was evaluated before and after the operation, respectively. Results All patients were followed up for 3-15 months, with an average of (8.7±0.5) months. The hospital stay was 5-7 days, with an average of (5.8 ±0.4) d. The findings showed that the pain of the knee was significantly reduced, and the VAS score was reduced from (7.6 ±2.2) points before the operation to (3.2 ±1.9) points at the last follow-up. Con-clusion The proximal fibula osteotomy can alleviate the symptoms of knee osteoarthritis, with the advantages of less trauma, less cost, and less difficulty in operation, which justifies widespread use.

BACKGROUND:Recurrent lumbar disc herniation is very common in the clinic. Most patients have adjacent segment degeneration at the same time, and second operation is more difficult than first time. <br> OBJECTIVE:To investigate the more than 6-month fol ow-up results of posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation. <br> METHODS:Complete fol ow-up data of 40 patients with recurrent lumbar disc herniation, who were treated from January 2010 to January 2012, were retrospectively analyzed. Al secondary surgeries received posterior laminectomy, discectomy, interbody fusion and pedicle screw fixation. Japanese Orthopaedic Association (29 scores) and low back pain Visual Analog Scale were used to assess neurological functions and rational symptoms before and after treatment and during final fol ow-up. Therapeutic effects after treatment were assessed and improvement rate was calculated. <br> RESULTS AND CONCLUSION:40 patients were fol owed up from 6 to 36 months. Japanese Orthopaedic Association scores were significantly improved at 2 months after treatment and during final fol ow-up compared with pre-treatment (P<0.05). Visual Analog Scale scores were significantly improved at 2 months after treatment and during final fol ow-up compared with pre-treatment (P<0.05). These data suggested that first surgery destroys stability of spine, speeds up adjacent degeneration. Posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation can solve some problems such as complete decompression,stable&nbsp;integration, scar adhesion and oppression, and obtain good repair effects.

Objective To investigate the diagnostic value and postoperative outcomes of transforaminal endo-scopic discectomy and radiofrequency thermal annuloplasty in treatment of low back pain. Methods Transforaminal endoscopic discectomy and radiofrequency thermal annuloplasty via the posterolateral approach, were used to treat patients with discogenic low back pain (n=60) between June 2012 and June 2013. The preoperative low back pain VAS score was 6.71 ± 1.13, and the ODI score was 74.31 ± 9.73. All patients underwent transforaminal endoscopic discectomy and radiofrequency thermal annuloplasty in combination with facet joint blockage. The low back pain VAS score and ODI score were measured at 1 week after the operation and the last follow-up. The MacNab score was mea-sured at the last follow-up. Results The last follow-up VAS score was 1.37 ± 0.87, with the improvement rate of (80± 9)%, and the ODI score was 16.98 ± 5.86, with the improvement rate of (77 ±10)%. The scores at each postoperative time point was significantly lower than the preoperative scores (P<0.01). According to MacNab score system, the treat-ment efficacy was excellent in 17 cases, good in 41, and acceptable in 2 cases at the last follow-up. The total effective rate was 100%, and the excellence rate was 97%. Low back pain recurred in 3 patients (5%), and 2 patients devel-oped protrusion of intervertebral disc necessitating open surgery (3.33%). Four patients experienced nerve root hyper-algesia and sun-burn syndrome (6.67%) and were given nerve nutrition and non-steroidal drugs for the treatment, and the symptoms were relieved after 1 week. Conclusion Transforaminal endoscopic discectomy and radiofrequency thermal annuloplasty is a safe and effective treatment for discogenic low back pain. In skillful hands, this technique is associated with low incidence of operative complications and evidenced surgical outcomes.

布鲁杆菌的贮存宿主很多，已知有六十多种动物（家畜、家禽、野生动物、驯化动物）可以作为布鲁杆菌贮存宿主。布鲁杆菌病往往先在家畜或野生动物中传播，随后波及人类，是人畜共患的传染病。布鲁杆菌病性脊柱炎是人畜共患，近几年全国发病率呈上升趋势，局部地区流行严重。虽然布鲁杆菌病性脊柱炎多可通过保守治疗治愈，但常出现椎间盘炎、椎管脓肿、迟发性神经损伤致剧烈疼痛，严重影响脊柱活动。2011年11月至2013年4月对45例布鲁杆菌病性脊柱炎行一期病灶清除植骨融合＋脊柱内固定手术联合药物治疗，取得良好效果。报告如下。