Objective To explore the clinical effects and application value of microendoscopic discectomy via spinal posterior access in the treatment of lumbar disc herniation. Methods Microendoscopic intervertebral space discectomy was performed for 152 patients with prolapse of lumbar intervertebral disc. The follow-up of clinical effects was carried out. Results 113 patients were followed up for 3 to 19 months. By Macnab standards, the rusult was excellent in 86 patients, good in 21, fair in 4, and poor in 2. The excellent and good rate was 94.6%. Conclusion Microendoscopic discectomy is an ideal method to treat lumbar disc herniation if the indications are suitable, for it is minimally invasive, and provides rapid postoperative recovery, good operation safety, as well as reliable effects.

Thirty-two cases of calcaneodynia were treated with high-energy vibration wave combined with external application of Shuangbo Ointment (Group 1) and other 32 with high-energy vibration wave only (Group 2) as control. The results showed that the markedly effective rates of short-term treatment (3 weeks) and long-term treatment (3 months) were 56.25% and 84.37% in Group 2, and 81.25% and 93.75% in Group 1 respectively. It is suggested that high-energy vibration wave combined with external application of Shuangbo Ointment exerts a better effect for calcaneodynia, and can decrease the occurrence of hematoma and periosteum stripping induced by high-energy vibration wave.

Objective To evaluate the effectiveness and safety of isometric neck strength training for the treatment of neck-type cervical syndrome.Methods The qualified patients with neck-type cervical syndrome were divided into two groups by stratified randomization: the treatment group(N=55)received isometric neck strength training,and the control group(N=40) received manipulation treatment.Two weeks constituted one treatmeat course.Visual Analog Scale(VAS) and Vernon Cervical Disability Index(VCDI) were used to evaluate the efficacy,and the safety was also monitored.Results All of the 95 enrolled patients were followed up for 3~11.4 months.No aggravation was found in the treatment group,but in the control group one patient developed into cervical spondylotic radiculopathy and one patient developed into sympathetic cervical spondylosis.The frequency of serious neck pain attack within 3 months was 6.65?2.62 times in the control group and 2.27?1.50 times in the treatment group,the difference being significant(P0.05);the result of follow-up on the 3rd month after treatment showed that the difference of VCDI score was significant between the two groups(P

Objective To explore the effect of gravitational traction on height change of degenerative disc of New Zealand white rabbit.Methods In order to create intervertebral disc degeneration models, the right front side of the annulus fibrosus of lumbar vertebrae of rabbits were damaged by 16-gauge needle. After confirming the success of modeling, 20 animal models were randomized into 2 groups, 15 of which received a routine gravitational traction using a model of our own design, 30 min per day, for 8 weeks, while the control group received no treatment at all. Radiographic exam were performed in the 2nd, 4th, 6th and 8th week, after intervention and the disc height index percent (DHI%). Results Compared to the baseline, DHI% increased significantly 2 and 4 weeks after gravitational traction (P<0.05), and there was no further effect as the traction continued. However, compared to the control group, an improvement of DHI% was found on all the time points in the gravitational traction group (P<0.001). Conclusion Gravitational traction may delay and inhibit intervertebral disc degeneration by increasing height of degenerated disc of New Zealand white rabbit.

Objective: To evaluate the clinical outcomes of posterior percutaneous endoscopic cervical discectomy (PPECD) for cervical disc herniation. Methods: A total of 23 patients who underwent PPECD for cervical disc herniation at Department of Spine Surgery, Guangdong Provincial Hospital of Chinese Medicine from August 2014 to April 2016 were reviewed. The mean age of the 17 males and 6 females was 49.5 years (range from 31 to 61 years). All patients had unilateral upper limb radiating symptoms, 13 patients with right upper limb radiating pain and 10 patients with left upper limb radiation pain, 17 patients with neck pain symptoms. Responsible segment: left C_4-5 1 case, right C_4-5 2 cases, left C_5-6 4 cases, right C_5-6 8 cases, left C_6-7 5 cases, right C_6-7 3 example.Operating time, length of hospitalization, complications, neck and arm Visual analog scale(VAS), and Neck Disability Index(NDI) were evaluated. The excellent and good rate of surgery was evaluated by using the Odom criteria. Harrison method was used to measure cervical curvature. The Cobb angle of the surgical segment was measured on the X-ray, and the range of motion (ROM) was calculated. The changes of the cervical curvature and the surgical segment ROM were compared pre- and post-operation. Results: The operation time was 94.1 min (range from 80 to 150 min). The average length of hospital stay was 4.8 days. The mean follow-up period was 23.5 months (range from 15 to 35 months). The preoperative arm VAS score was 6.95±0.88, 1-week postoperative arm VAS score was 2.09±0.67, the last follow-up arm VAS score was 1.04±0.98. The preoperative neck VAS score was 3.04±0.77, 1-week postoperative neck VAS score was 1.52±0.51 and the last follow-up neck VAS score was 0.61±0.78. The 1-week postoperative and last follow-up arm and neck VAS scores were significantly reduced compared with pre-operation (P<0.01). Compared with 1 week after surgery, the last follow-up of the arm and neck VAS score further reduced, the difference was statistically significant (P<0.01). The preoperative NDI was (58.52±4.98)%, the 1-week postoperative NDI was (33.74±4.72)%, the last follow-up NDI was (19.22±3.23)%. The 1-week postoperative and last follow-up NDI was significantly improved compared with pre-operation (P<0.01). Compared with 1 week after surgery, the last follow-up of the NDI further improved, the difference was statistically significant (P<0.01). The 1-week postoperative cervical curvature was (14.65±2.89)°, and it was improved compared with preoperative(14.23±3.06)°, the difference was statistically significant (P<0.05) . The last follow-up was cervical curvature(14.64±2.68)°, there was no significant difference compared with preoperative (P> 0.05). The preoperative surgical ROM was(5.37±1.83)°, 1-week postoperative was(5.53±1.52)°, and the last follow-up was (5.62±1.48)°, there was no significant difference pre-operative and post-operation (P> 0.05). The excellent and good rate was 91.3% (excellent in 16 cases, good in 5 cases, 2 cases). There was no nerve root injury, cerebrospinal fluid leakage, wound infection, and other complications. Conclusions PPECD is a sufficient and safe supplement for cervical disc herniation, its recent clinical efficacy was good. And it has no significant effect on cervical stability.

Objective:To analyze the effectiveness and safety of robot-assisted percutaneous endoscopic posterior/transforaminal lumbar interbody fusion (RPE-P/TLIF) in the treatment of lumbar spinal stenosis with instability.Methods:From September 2018 to April 2022, 26 patients with lumbar spinal stenosis combined with lumbar segmental instability were treated with RPE-P/TLIF at the Department of Minimally Invasive Spine Surgery, Guangdong Provincial Hospital of Chinese Medicine. There were 13 males and 13 females, with a mean age of 57.92±7.09 years (range, 44 to 75 years) and a mean body mass index of 24.05±2.64 kg/m 2 (range, 19.38 to 29.06 kg/m 2). A total of 31 segments were included, including 21 cases of single-segment surgery (L 3, 4 in 2 cases, L 4, 5 in 18 cases, and L 5S 1 in 1 case) and 5 cases of two-segment surgery (all L 3-L 5). Before surgery and at 1, 6, and 12 months after surgery, as well as at the final follow-up, the visual analogue scale (VAS) was used to assess back pain and lower limb pain, and the Oswestry disability index (ODI) was used to evaluate spinal nerve function. Clinical efficacy was evaluated using the MacNab criteria at the final follow-up. Imaging evaluation indicators included pre- and post-operative intervertebral space height, lumbar lordosis angle, fusion rate, and accuracy of pedicle screw placement. Results:The follow-up time for the 26 patients was 42.88±10.09 months (range, 12 to 55 months). The mean operation time was 156.54±33.50 min, and the mean postoperative drainage volume was 27.23±20.20 ml. The VAS scores for back pain and lower limb pain before surgery were 4.35±1.23 and 6.08±0.63, respectively. These scores decreased to 2.08±0.69 and 1.85±0.54 at 1 month postoperatively, 1.85±0.54 and 0.77±0.59 at 6 months, 0.96±0.53 and 0.62±0.57 at 1 year, and 0.88±0.52 and 0.58±0.50 at the final follow-up, respectively. The differences were statistically significant ( F=85.943, P=0.001; F=547.946, P=0.014). The ODI scores before surgery and at 1, 6, 12 months after surgery, and at the final follow-up were 55.38%±5.89%, 28.38%±3.849%, 17.77%±2.67%, 12.58%±1.88% and 12.12%±2.27% respectively, with statistically significant differences ( F=783.289, P=0.010). According to the MacNab criteria, at the final follow-up, there were 18 cases of excellent, 6 cases of good, and 2 cases of fair, with an excellent and good rate of 92.3%. A total of 114 percutaneous pedicle screws were implanted with grades A, B and C being 109, 4 and 1, respectively. The preoperative, postoperative, and final follow-up intervertebral space heights were 10.55±1.96, 13.53±1.37, and 12.54±1.42 mm respectively, with statistically significant differences ( F=42.190, P<0.001). And the lumbar lordosis angles were 35.81°±10.80°, 35.69°±11.07°, and 36.08°±11.29° respectively, with no statistically significant differences ( P>0.05). At 12 months postoperatively, bone fusion was achieved in 25 cases, with a fusion rate of 96% (25/26). Conclusion:RPE-P/TLIF for lumbar spinal stenosis combined with lumbar instability were favorable. Being a safe and effective minimally invasive surgical option, it effectively enhanced the intervertebral space height in the surgical segment with fewer complications.