Diskoscope combined with screw-rod fixation was used in the treatment of lumbar spinal stenosis complicated by degree Ⅰ dislocation of 48 cases, with an average operation time 150 min, average amount of bleeding 160 mL, average admission for 14 days, and an average follow-up of 18 months. Four cases developed pain in lower limb caused by traction of nerve root, and the symptoms disappeared after symptomatic treatment. No loosening, nail breakage or rod breakage, no infection or inflammatory reaction was found after implantation. Clinical evaluation excellent rate was 95.8 % , indicating that diskoscope combined with screw-rod fixation after spinal fusion for the treatment of decompression has been effective, and the screw-rod system achieves an effective fixation, reduction of spondylolisthesis, and spinal stability.

BACKGROUND: Beta-tricalcium phosphate (β-TCP)/alpha-calcium sulfate hemihydrate (α-CSH) artificial composite bone has a porous morphology and good biocompatibility, and it is helpful to improve the fusion rate in a spinal fusion model, which however has not yet been confirmed.OBJECTIVE: To investigate the preparation methods, biocompatibility and application effect of β-TCP/α-CSH composite bone in the spinal fusion model.METHODS: (1) Calcium sulfate dihydrate under certain conditions and at a proper temperature can be dehydrated to prepare α-CSH. Healthy bovine cancellous bone was decellularized, degreased and sintered under the certain condition and at the certain temperature to prepare β-TCP particles. Then, the β-TCP particles were dissolved in anhydrous ethanol, suspended, dried, and then used to prepare the β-TCP/α-CSH composite bone. Osteoblasts from the rabbit periosteum were co-cultured with the composite bone, and then cell morphology, adhesion and proliferation were observed. (2) Twenty New Zealand white rabbits were selected to make bilaterally posterolateral spinal fusion models of the multiple thoracic vertebrae, in which β-TCP/α-CSH composite bone was implanted into the left side (experimental group) and autogenous bone implanted into the right side (control group). The spinal fusion rate was compared between the two groups.RESULTS AND CONCLUSION: (1) Under the phase contrast microscope, a relatively small amount of L929 cells adhered to the composite bone after 3 days of co-culture, while the number of adherent cells became relatively dense. Under the scanning electron microscope, there were many crystalline particles on the surface of the composite bone,indicating a higher number of adherent cells on the composite bone surface. (2) The spinal fusion rate was increased at 4 weeks after implantation of β-TCP/α-CSH composite bone, which was significantly higher than that after implantation of autogenous bone (P < 0.05). (3) At 4 weeks after autogenous bone implantation, the bone trabecular bone was scarce and clumped, and newborn bone tissues and the boneless autograft bone were dominant. After 8 weeks after spinal fusion, the newborn bone tissues around the autograft were further increased. At 4 weeks after β-TCP/α-CSH composite bone implantation, there was no degradation of debris, but existed a few new bone tissues; at 8 weeks after implantation,the composite bone was surrounded by newborn bone tissues, and thickened trabecular bone and degradation of the composite bone were found. To conclude, the prepared β-TCP/α-CSH composite bone can achieve a higher fusion rate in the spinal fusion model.

Objective To evaluate the indications,techniques and effects of high speed drill assisted cervical pedicle screw-rod system in treatment of cervical interlocking dislocation.Methods A retrospective review was made on data of 13 cases of cervical interlocking dislocation undergone pedicle screw-rod fixation and reduction with assistance of high speed drills from December 2006 to July 2011.Dislocation localized in C3/4 (n =3),C4/5 (n =5),C5/6 (n =4) and C6/7 (n =1) respectively.Causes for injury contained cervical hyperextension due to traffic accidents (n =7) and a fall from the height (n =6).Two remained neurological intact,seven were combined with syndrome of central canal damage,and four had paraplegia.All the 13 cases received posterior pedicle screw fixation and reduction within 7 days after injury.Pedicle screws were implanted on adjacent segment of cervical spine with unlocking the interlocked small joints by a distraction device.Results All 13 cases obtained good reduction,including eight with complete anatomic reduction and five with 1-2 mm of vertebral slight slippage.Fifty-two screws were inserted and 49 pedicle screws were put in place except for the excursion in three pedicle screws on the postoperative radiographic and CT scans.There was no injury of spinal cord,nerve root or vertebral artery during operation.The patients showed significant improvement in sensory and motor function of the upper extremities in the follow-up of 12-36 months.One case had screw breakage at postoperative three months with no nerve symptoms.Conclusion High speed drill assisted pedicle screw-rod system is suitable for treatment of cervical interlocking dislocation,for its reduction process accords with the biomechanics and allows decompression therapy.

Objective:To systematically integrate qualitative researches on the financial toxicity experience of cancer patients, so as to provide reference for formulating intervention strategies for financial toxicity in cancer patients.Methods:Qualitative studies on financial toxicity experience of cancer patients were searched in Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, Wanfang data, and China Biology Medicine disc, with a search period from database establishment to August 31, 2023. The quality of the included literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence Based Health Care Center in Australia. The aggregation integration method was used to integrate the results.Results:A total of 12 articles were included, and 68 research results were extracted and categorized into 15 new categories. Four integrated results were obtained, including anxiety and stress under financial difficulties, relying on family members to start a new in adversity, and dancing together with treatment and life to write a new article, and great expectations for the future.Conclusions:Pay attention to the financial toxicity of cancer patients, actively seek response strategies, and bring benefits to cancer patients.