Background Kümmell disease usually occurs in the elderly osteoporosis population and develops gradually into symptomatic, progressive kyphosis of the spine. Several alternative surgical procedures, including vertebroplasty, kyphoplasty, and osteotomy, can be chose for the treatment of the disease.However, current surgical methods to deal with stage III Kümmell disease are less satisfying. Method A modi ed technique of intravertebral insertion of interbody fusion cage with posterior spine stabilization was applied to treat stage III Kümmell disease. Results This study details a modi ed technique applied in a patient with stage III Kümmell disease, showing signi cant improvement in pain relief, anterior column height recovery, and kyphotic angle correction. And no complications was reported during our follow-up.Conclusions Intravertebral insertion of interbody fusion cage via transpedicular approach provides advantages of acceptable correction of kyphosis, bony fusion, minimal invasion. Thus, our method was a good alternative choice for stage III Kümmell disease.

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Medical carbon material has been extensively studied due to their excellent biological and mechanical properties. However, the dissociation of the surface carbon particles greatly limited the application of medical carbon material (MCM). To overcome this defect, we introduced the polydimethylsiloxane, a polymer-coating material (PCM) that possesses acceptable biocompatibility, into medical carbon material to prevent the shedding of carbon debris. Additionally, to reduce inflammatory reactions and increase surface hydrophilicity, ferulic acid, also called Chinese medicine coating material (CCM), was used to modify the surface of polymer-coating material. We investigated the proliferation and adhesion of NIH-3T3 cells onto MCM, PCM and CCM in vitro. We showed that CCM exhibited excellent biological activity to promote cell growth. Twelve weeks after CCM implantation, bone defects were repaired, and the material showed acceptable chemical stability. The results indicated that the CCM composite possesses excellent mechanical property and favorable biocompatibility, which can be used for clinical bone repair.

Acute noncompressive nucleus pulposus (NP) extrusion has been widely described in veterinary medicine, especially in dogs and cats; however, cases have rarely been reported in humans. We report a rare case of acute pain caused by a hydrated NP. Magnetic resonance imaging revealed an obvious hyperintense signal on T2-weighted images at the L5/S1 segments, while computed tomography imaging and radiography revealed a mildly herniated disc at the L4/5 level and slight lumbar spondylolisthesis at the L5/ S1 segments. The operation was performed to confirm the presence of a red and swollen nerve root on the right side of the hydrated L5/S1 segment. The patient's severe pain disappeared, and full recovery was achieved months after surgery. Thus, our case demonstrated a probable lumbar acute noncompressive NP extrusion in humans and reported associated symptoms and imaging characteristics. In such circumstances, surgical management is indicated and may be associated with a good outcome.

Background:Cervical spondylotic myelopathy patients with multiple segments are usually treated with the posterior approach. But expansive open laminoplasty (ELAP) often results in heavy, rigid, and acid bilges feelings in the neck, shoulder, and back, collectively known as axial symptoms. Objective: To evaluate the effect of modified posterior cervical ligament complex reconstruction and single-door laminoplasty with titanium plate fixation on postoperative axial symptoms in patients. Methods: A retrospective analysis conducted from June 2016 to March 2018 collected more than 132 cases of cervical spondylotic myelopathy at our institute. Group A includes 74 patients and Group B includes 58 patients who use different surgery method. Gender, age, operation time, intraoperative blood loss, post-operative drainage volume, and follow-up time, Visual analogue scoring (VAS), cervical curvature index (CCI) and the cross-sectional area of the posterior cervical muscles of the two groups were recorded. Results: There was statistical significance in the incidence of axial pain 3 months after surgery (P =0.001), 6 months after surgery (P =0.006), and 1 year after surgery (P =0.015). And the VAS score was decreased in group A 1 week (P <0.0001), 1 ,3 month(P=0.0001), 6 months(P=0.0076), and 1 year(P=0.0085) post-surgery compared to group B. Also the CCI and the posterior cervical muscle area between groups A and B (P < 0.0001).Conclusion: Modified single open-door laminoplasty could relieve cervical axial pain in patients with cervical spondylotic myelopathy.