Objective To explore and analyze the influence of endoscopic lumbar discectomy on limb function and quality of life in patients with lumbar disc prolapse.Methods 90 cases of lumbar intervertebral disc protrusion were selected,and they were divided into control group and observation group according to the operation method,45 cases in each group.The control group was given open lumbar disc excision treatment,the observation group was given percutaneous endoscopic lumbar disc resection treatment.The perioperative therapeutic index,physical function and quality of life were compared between the two groups.Results The intraoperative blood loss,time in bed,hospital stay,postoperative VAS score of the control group were (60.21 ± 20.32) min,(30.36 ± 14.25) mL,(26.96 ± 9.69) d,(8.21 ± 2.36) d,(5.12 ± 1.36) points,respectively,which of the observation group were (58.96 ± 19.88) min,(12.88 ± 10.28) mL,(100.69 ± 18.75) d,(12.99 ± 3.88) d,(1.98 ± 0.33) points,respectively.Compared with the control group,the observation group had less intraoperative blood loss,shorter time in bed,shorter hospital stay,lower postoperative VAS score,the differences were statistically significant (t =4.25,4.66,5.12,5.78,6.12,all P ＜ 0.05).The excellent and good rate of the control group was 89.89％,which of the observation group was 93.33％,there was no significant difference between the two groups (x2 =7.68,P ＞ 0.05).After treatment,the physical function,role function,emotional function,cognitive function and social function score of the control group were (7.89 ± 0.78) points,(7.99 ± 1.25) points,(7.84 ± 0.65) points,(7.65 ± 0.75) points,(7.45 ± 0.77) points respectively,which of the observation group were (8.96 ± 1.78) points,(8.75 ± 1.12) points,(8.56 ± 0.88) points,(8.42 ± 0.66) points,(8.56 ± 1.47) points,respectively.Compared with before treatment,the physical function,role function,emotional function,cognitive function and social function score in the two groups after treatment were higher.After treatment,compared with the control group,the scores increased more significantly in the observation group (t =6.55,7.56,7.88,7.56,7.89,all P ＜ 0.05).Conclusion Endoscopic resection and open lumbar disc excision technique in treatment of patients with lumbar intervertebral disc protrusion of lumbar can obtain similar curative effect,but the former has less incision,less intraoperative blood loss,postoperative recovery fast,can better improve the patients' quality of life.

Objective:To report our experience in diagnosis and treatment of posterior atlantoaxial dislocation with odontoid retrolisthesis.Methods:A retrospective study was conducted of the 5 patients who had been treated from July 2012 to August 2018 at Department of Orthopaedics, General Hospital of Southern Theater Command for posterior atlantoaxial dislocation. They were 4 men and one woman, aged from 34 to 67 years (average, 47 years). All of them had a history of trauma. Of them, 4 were complicated with odontoid fracture and one with congenital free os odontoideum. Their posterior atlantoaxial dislocation ranged from 3 to 9 mm (average, 6 mm). By the American Spinal Injury Association (ASIA) grading system, their preoperative spinal injury was rated as grade B in one, as grade C in 3 cases and as grade D in one. All the 5 patients underwent skull traction at 10° flexion. Surgical trans-oralpharyngeal atlantoaxial reduction and internal fixation was performed for the one patient whose reduction had not been achieved by traction while posterior atlantoaxial screw-rod fixation or anterior odontoid screwing was conducted for the 4 patients whose reduction had been achieved by traction. The distance of posterior atlantoaxial dislocation was measured to evaluate their reduction and ASIA grade system was used to assess their spinal function after operation.Results:The postoperative distance of posterior atlantoaxial dislocation was 0 mm, showing a reduction rate of 100%. The 5 patients were followed up for 6 to 36 months (average, 15 months). By the ASIA grade system, the postoperative functional recovery of the spine was grade D in 4 cases and grade C in one. No implant loosening or breakage occurred.Conclusion:As a kind of high-energy hyperextension injury, posterior atlantoaxial dislocation is rare in clinic, but an appropriate treatment can be adopted to deal with its different clinical types to achieve good outcomes.

Purpose To explore the subcortical structure characteristics in autism spectrum disorder(ASD)aged 12-18 years old and the developmental characteristics of abnormal regions with age.Materials and Methods A total of 102 adolescents aged 12-18 years old meeting the diagnostic criteria for ASD in diagnostic and statistical manual,fifth edition and 42 gender and age matched typically developing controls were enrolled from March 2013 to January 2021 in Peking University Sixth Hospital.Structural magnetic resonance imaging scans were performed on all participants.The freeSurfer software was used to process the 3D T1 images of all participants and segment the subcortical regions.Covariance analysis was performed to compare the volumes of subcortical regions between the two groups.Analysis of variance and covariance were used to explore the developmental differences of brain regions with significant group differences within the ASD and control groups in the age groups of 12-13,14-15 and 16-18,as well as between the ASD and control groups in these age groups.Results Compared to the control group,the volumes of the right caudate,right pallidum,left hippocampus,and corpus callosum anterior region were significantly increased in the ASD group(F=4.522,5.955,7.191,5.326,P<0.05).The volume of the corpus callosum anterior region showed significant differences among the aged 12-13,14-15 and 16-18 years groups of the control group(F=5.248,P=0.01),while there was no significant difference among these three groups of the ASD group(F=2.345,P=0.101).Conclusion Adolescents with ASD aged 12-18 years show abnormalities in multiple subcortical structures,and the developmental characteristics of the corpus callosum anterior region are different from typically developing controls,suggesting that the brains of adolescents with ASD have distinct developmental features.