Objective:To investigate the early clinical outcomes of anterior cervical discectomy and fusion (ACDF) in the treatment of two-segment cervical spondylotic myelopathy (CSM) using a cervical soft endoscopic minimally invasive system.Methods:A retrospective follow-up study was conducted on the medical records of 23 patients with two-segment cervical myelopathy who underwent ACDF using a soft endoscopic cervical spine minimally invasive system at the Third Affiliated Hospital of Southern Medical University between October 2022 and December 2023. The cohort included 15 males and 8 females, aged 37-79 years (58.52±11.77 years). The affected cervical segments included: C 3, 4 and C 4, 5 in 2 cases; C 3, 4 and C 5, 6 in 3 cases; C 4, 5 and C 5, 6 in 10 cases; C 5, 6 and C 6, 7 in 7 cases; and C 4, 5 and C 6, 7 in 1 case. Clinical outcomes were evaluated based on the Japanese Orthopaedic Association (JOA) scores and visual analog scale (VAS) for neck and shoulder pain, assessed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Additional data recorded included incision length, intraoperative blood loss, operative time, postoperative complications, and the presence of prevertebral soft tissue edema. The improvement rate of JOA scores at the final follow-up was also calculated. Results:All patients successfully underwent surgery and completed follow-up, with follow-up durations ranging from 3 to 6 months (4.01±0.98 months). The mean operative time was 80.09±22.66 min (range: 53-127 min), and the mean incision length was 3.25±0.32 cm (range: 3-4 cm). Estimated blood loss ranged from 10 to 100 ml, with a mean of 34.78±24.1 ml. Postoperative drainage ranged from 0 to 80 ml (mean: 23.13±26.1 ml), and postoperative hospitalization durations ranged from 4 to 12 days (6.83±2.59 days). JOA scores improved significantly from a preoperative median of 9.00(8.00, 10.00) to 12.00(11.00, 14.00) at 1 week, 13.00(12.00, 14.00) at 1 month, and 15.00(15.00, 16.00) at 3 months postoperatively (χ 2=220.492, P<0.001). VAS scores for neck and shoulder pain also improved significantly from a preoperative median of 5.00(4.00, 6.00) to 3.00(2.00, 3.00) at 1 week, 2.00(2.00, 3.00) at 1 month, and 2.00(1.00, 2.00) at 3 months postoperatively (χ 2=170.869, P<0.001). No postoperative complications such as dysphagia, hoarseness, nerve injury, cerebrospinal fluid leakage, or intraspinal hematoma were observed. Imaging revealed no significant prevertebral soft tissue edema. At the final follow-up, the improvement rate of JOA scores resulted in 14 cases rated as excellent and 9 as good. Conclusions:ACDF using a cervical soft endoscopic minimally invasive system demonstrates satisfactory clinical outcomes for the treatment of two-segment CSM. This technique reduces the incidence of common complications associated with both open and traditional endoscopic surgeries.

Objective:To investigate the early clinical outcomes of anterior cervical discectomy and fusion (ACDF) in the treatment of two-segment cervical spondylotic myelopathy (CSM) using a cervical soft endoscopic minimally invasive system.Methods:A retrospective follow-up study was conducted on the medical records of 23 patients with two-segment cervical myelopathy who underwent ACDF using a soft endoscopic cervical spine minimally invasive system at the Third Affiliated Hospital of Southern Medical University between October 2022 and December 2023. The cohort included 15 males and 8 females, aged 37-79 years (58.52±11.77 years). The affected cervical segments included: C 3, 4 and C 4, 5 in 2 cases; C 3, 4 and C 5, 6 in 3 cases; C 4, 5 and C 5, 6 in 10 cases; C 5, 6 and C 6, 7 in 7 cases; and C 4, 5 and C 6, 7 in 1 case. Clinical outcomes were evaluated based on the Japanese Orthopaedic Association (JOA) scores and visual analog scale (VAS) for neck and shoulder pain, assessed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Additional data recorded included incision length, intraoperative blood loss, operative time, postoperative complications, and the presence of prevertebral soft tissue edema. The improvement rate of JOA scores at the final follow-up was also calculated. Results:All patients successfully underwent surgery and completed follow-up, with follow-up durations ranging from 3 to 6 months (4.01±0.98 months). The mean operative time was 80.09±22.66 min (range: 53-127 min), and the mean incision length was 3.25±0.32 cm (range: 3-4 cm). Estimated blood loss ranged from 10 to 100 ml, with a mean of 34.78±24.1 ml. Postoperative drainage ranged from 0 to 80 ml (mean: 23.13±26.1 ml), and postoperative hospitalization durations ranged from 4 to 12 days (6.83±2.59 days). JOA scores improved significantly from a preoperative median of 9.00(8.00, 10.00) to 12.00(11.00, 14.00) at 1 week, 13.00(12.00, 14.00) at 1 month, and 15.00(15.00, 16.00) at 3 months postoperatively (χ 2=220.492, P<0.001). VAS scores for neck and shoulder pain also improved significantly from a preoperative median of 5.00(4.00, 6.00) to 3.00(2.00, 3.00) at 1 week, 2.00(2.00, 3.00) at 1 month, and 2.00(1.00, 2.00) at 3 months postoperatively (χ 2=170.869, P<0.001). No postoperative complications such as dysphagia, hoarseness, nerve injury, cerebrospinal fluid leakage, or intraspinal hematoma were observed. Imaging revealed no significant prevertebral soft tissue edema. At the final follow-up, the improvement rate of JOA scores resulted in 14 cases rated as excellent and 9 as good. Conclusions:ACDF using a cervical soft endoscopic minimally invasive system demonstrates satisfactory clinical outcomes for the treatment of two-segment CSM. This technique reduces the incidence of common complications associated with both open and traditional endoscopic surgeries.

BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma. OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty. METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were"arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted".The Chinese search terms were"robot-assisted,robotic arm,knee osteoarthritis,arthritis".After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed. RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.

Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.

Objective To investigate the effect of single operation Mammotome system on breast benign tumor patients.Methods 86 cases of benign breast cancer patients admitted from Jan.2011 to Dec.2015 were divided into the control group (43 cases) and the observation group (43 cases) according to the random number table method.The control group were treated by traditional breast lesion resection and the observation group were treated by single operation of Mammotome system.The mean time of operation,the average blood loss and the size of surgical scar were recorded.The number of patients with deformity of breast and complications was recorded.The satisfaction of the two groups was evaluated by questionnaire.The recurrence rate of the two groups was statistically analyzed.Results The average operation time of the observation group was significantly shorter than that of the control group,and the scar size was significantly smaller than that of the control group (P＜0.05).The deformity rate of the observation group was 0％,significantly lower than that of the control group (11.6％).The satisfaction rate was 97.7％ in the observation group,significantly higher than that of the control group (83.7％,P＜0.05).The postoperative complication rate was 4.7％ in the observation group,significantly lower than that of the control group (18.6％,P＜0.05).There was no recurrence in the two groups during 6 months of follow-up.Conclusion The application of single breast operation Mammotome treatment for benign breast tumor has the advantages of simple operation,shorter operation time,less intraoperative blood loss and surgical scars.It also can reduce the postoperative complications,keep breast shape,reduce the recurrence rate,so as to improve the patient satisfaction.