ObjectiveThe purpose of this FE study was to analyze the biomechanical characteristics of different HS strategies used in the treatment of three-level CDDD (one-level CDA and two-level ACDF).MethodsWe validated the FE model of an intact cervical spine established by transferring the data, collected by 3D CT scan, to the FE software ABAQUS and comparing these data with the data from published studies. Then, the FE model of hybrid surgery was reconstructed to analyze the range of motion (ROM), facet joint force, and stress distribution on an ultrahigh molecular weight polyethylene (UHMWPE) core.ResultsThe current cervical FE model was able to measure the biomechanical changes in a follow-up hybrid surgery simulation. The total ROM of the cervical HS models was substantially decreased compared with the total ROM of the intact group, and the M2 (C3/4 ACDF, C4/5 CDA, and C5/6 ACDF) model had the closest total ROM to the intact group, but the facet joint force adjacent to the treatment levels showed very little difference among them. The stress distribution showed noticeable similarity: two flanks were observed in the center core, but the inlay of M2 was more vulnerable.ConclusionsThrough the comparison of ROM, the facet joint force after CDA, and the stress distribution of the prosthesis, we find that M2 model has a better theoretical outcome, especially in preserving the maximum total ROM.

Objective: Although the concept of Enhanced Recovery After Surgery (ERAS) has gradually become familiar with surgeons and applied in clinical practice in recent years, the current status of the experience and application of ERAS in Chinese mainland thoracic surgeons is still not clear. This study is based on the results of a questionnaire survey of ERAS-related issues among participating thoracic surgeons and nurses, and analyzes the current status of accelerated rehabilitation surgery in thoracic surgery using bioinformatics. Methods: We analyze the 720 valid questionnaires that participated in the first session of the ERAS West China Forum. The content of the questionnaire mainly includes two parts: one is the situation of the respondent’s unit and the basic situation of the individual; the other is to accelerate the 10 problems related to rehabilitation surgery. Results: (1) The clinical application status of ERAS is more than practice, and 68.3% of doctors and 57.8% of nurses agree with this view; 87.9% of doctors and 86.2% of nurses believe that the ERAS concept applies to all surgical procedures. (2) The main reason for the poor compliance of ERAS clinical application was that the program was immature, without consensus and norms (56.4% of doctors and 68.8% of nurses). (3) The best team combination for ERAS clinical implementation is surgical-based discipline collaboration and healthcare (61.5% of physicians and 72.2% of nurses). (4) 75.1% of doctors and 82.6% of nurses believe that the evaluation criteria of ERAS should be: comprehensive evaluation of average hospitalization days, patient experience and social satisfaction. Conclusions: Accelerated rehabilitation surgery in the application of thoracic surgery is still the idea is greater than practice, the main reason is the lack of clinically available norms and programs. We can achieve the findings and verify them using statistical study.

Objective: The purpose of this study was to analyze the biomechanical characteristics of the lumbar posterior dynamic devices: the Dynesys system and the BioFlex system. Methods: We validated the FE model of an lumbar spine (L3-S1) established by transferring the data, collected by 3D CT scan, to the FE software ABAQUS and comparing these data with the data from published studies. Then, were reconstructed by the lumbar posterior dynamic devices to analyze the range of motion (ROM) and stress distribution on the lumbar posterior dynamic devices. Results: The current lumbar FE model was able to measure the biomechanical changes in a follow-up surgery simulation. The total ROM of the surgery simulation models was substantially decreased compared with the total ROM of the intact group, and the Dynesys system group had the closest total ROM to the intact group. The maximal von Mises stress concentrate at the middle part of the screws in Dynesys system, but at the Nitinol memory loop in BioFlex system. The maximal stress level was only 49 MPa in Dynesys system, but 164 MPa in BioFlex system. Conclusion: Through the comparison of ROM and the stress distribution of the prosthesis, we find that the Dynesys system maybe has a better theoretical outcome.