For surgical treatment, herniation of traditional open surgery is the traditional approach and the representative operation for lamina windowing excision of nucleus pulposus. In recent years, the unilateral dual channel spine endoscopic technology (UBE/BESS) has caused extensive concern of spine surgery performer. This research compared the results of minimally invasive percutaneous treatment of severe lumbar disc herniation with foraminal single-channel endoscopy and unilateral biportal endoscopy (UBE). A retrospective study was conducted on 50 patients with severe disc herniation treated with minimally invasive percutaneous treatment in MinDong Hospital affiliated to Fujian Medical University from September 2019 to September 2021. According to different surgical methods, they were divided into two groups: foraminal single-channel endoscopic group and UBE dual-channel endoscopic group. There were 22 cases in the UBE surgery group and 28 cases in the interforaminal endoscopic group. The comparison included operation time, postoperative hospital stays, preoperative and postoperative pain scale (VAS), and postoperative MRI to observe the residual condition of prolapsed nucleus pulposus and the occurrence of complications. There were no significant differences between the UBE group and the interforaminal endoscopic group in incision length, operation time, postoperative hospital stays, and improvement of VAS score before and after surgery. In terms of postoperative nucleus pulposus residual rate and postoperative recurrence rate, the two-channel UBE group was significantly better than the single-channel interforaminal endoscopic group. The incidence of postoperative anemia in the interforaminal endoscopic group was significantly lower than that in the UBE group. In the treatment of severe disc herniation, UBE two-channel endoscopy has the advantages of lower recurrence rate, lower nucleus pulposus residual rate, shorter learning curve, and better field of vision than foraminal single-channel endoscopy, which is worth promoting in primary hospitals.

This study investigated the nanohydroxyapatite (nHA) prosthesis application effect based on CT-scanning data in spinal injury. This study chose 26 spinal injury patients treated in our hospital from September 2017 to September 2018, who were randomly divided into two groups. nHA prosthesis based on CT-scanning data was implanted in the nHA group, whereas titanium mesh was implanted in the titanium mesh group. Consequently, osteoblasts were cultured to test the biological activity of nHA and titanium alloy. In cell tests, we found osteoblasts could better adhere to nHA, and proliferation and activity were higher when planted on nHA material. After surgical treatment, all patients’ spinal symptoms (VAS score, JOA score, and Cobb angle) had improved and did not cause obvious inflammatory foreign body reactions. During a two-year follow-up, the fusion time and support settlement in the nHA group was lower, and the vertebral fusion rate and ASIA score were higher than those in the titanium mesh group. Thus, CT-scanning data could further improve the vertebral fusion rate in the nHA group. Consequentially, nHA prosthesis based on CT-scanning data is a better choice for spinal injury therapy.

Background The indirect reduction is one kind of micro-invasive technology. The most important mechanism of indirect reduction is traction.The purpose of this study was to independently develop a traction reduction device on lower limb fracture and explore the clinical effect of micro-invasive treatment on tibial fracture adopting this device. Methods A retrospective study was conducted on 21patients with tibial fracture adopted this device to assist fracture reduction during operation from August 2019 to June 2022. The cases included 10 tibial plateau fractures, 6 tibial shaft fractures and 5 distal tibia (pilon )fractures. 3 tibial shaft fracture cases were adopted intramedullary needle internal fixations, the others cases were adopted plate internal fixations.Demographic data, fracture type, perioperative data, and radiological evaluation were collected. Clinical outcomes were graded using Rasmussen function score and American orthopedic foot and ankle society (AOFAS) score. Results The cases were followed up from 12 to 33 months.All cases had no complications such as blood vessel and nerve injuries,infection and internal fixation fail. All cases got bony healing. The mean Rasmussen anatomy score before operation of tibial plateau cases was (6.60 ± 3.13), the score immediately after operation was (17.20 ± 1.03), and there was statistical significance difference between two groups(P༜0.05). The mean Rasmussen function score of tibial plateau fracture cases at the last follow-up was(28.20 ± 1.55).The mean length difference between both lower limbs of tibia shaft fracture cases immediately after operation was (2.17 ± 2.04) mm, and the mean varus-valgus angulation of tibia shaft fracture immediately after operation was (1.67 ± 0.82)°, the mean fracture anteroposterior angulation of tibia shaft fracture immediately after operation was (2.00 ± 1.10)°. The Burwell-Charnley radiological assessment immediately after operation of distal tibia cases was as follow, 5 cases got anatomical reduction and 1 got good reduction. The mean AOFAS score of ankle and foot function at the last follow-up was( 93.60 ± 5.73). Conclusions The traction reduction device on lower limb fracture is safe effective to application, convenient to use, and has definite reduction effect. It can be applied in supine, lateral and prone positions, and be applied to micro-invasive treatment on complex tibia fracture.

Background The purpose of this study was to describe the efficacy of the UBE (unilateral biportal endoscopy, UBE) technique in treating lumbar disc herniation after the failure of PELD (percutaneous endoscopic lumbar discectomy, PELD). Methods From December 2019 to December 2021, the clinical data of 21 patients with lumbar intervertebral disc herniation who recurred after PELD and revision with the UBE technique were retrospectively analyzed in our institution. To observe the clinical efficacy and imaging results of UBE in the treatment of recurrent lumbar disc herniation. Preoperative and postoperative VAS scores (visual analog scale, VAS), intraoperative blood loss (assessed by preoperative and postoperative hemoglobin, Hgb); Postoperative re-examination of MRI to observe the space-occupying situation of the prolapsed nucleus pulposus spinal canal (assessed by preoperative and postoperative spinal canal area (cm2)); postoperative infection (assessment by preoperative and postoperative WBC and CRP levels), and finally statistical analysis. The time of revision surgery, the length of the surgical incision, the amount of sterile saline used during the operation, and the mean hospitalization time were also observed. Results The average hospital stay was 5.25 ± 3.35 days. The average surgical incision length was 2.45 ± 0.55 cm, the mean operation time was 50.25 ± 3.15 minutes, and the mean intraoperative sterile saline usage was 7125.50 ± 68.55 ml. The VAS score and Hgb of the patients before and after operation were significantly decreased, and the condition of the prolapsed nucleus pulposus and the space-occupying spinal canal was significantly improved in the postoperative MRI observation, all P༜0.05, the difference was statistically significant; the P values ​​of WBC and CRP changes before and after operation All were ༞0.05, and the difference was not statistically significant; No patient had an infection, nerve, blood vessel injury, cerebrospinal fluid leakage after surgery. Conclusion UBE can effectively treat the recurrence of lumbar intervertebral disc herniation after transforaminal surgery, but there are some shortcomings such as a large amount of sterile saline and anemia during operation.