BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.

BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery.
OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation.
METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle.
RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P<0.05). No significant difference in height of injured vertebrae and the Cobb angle was detectable among the three groups at 3 days after fixation (P>0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.

Objective: To investigate the effects of 1, 25-dihydroxy vitamin D₃[1, 25(OH)₂D₃] on food allergy(FA) in mice and its mechanism. Methods: A total of 40 BALB/c mice were randomly divided into 5 groups, 8 in each group, including control group (group C) and FA model group (FA group), according to the dose of 1, 25(OH)₂D₃ intervention, the mice of the FA group were divided into FA₀ group (0), FA_l group [10 μg/(kg·d)], FA_m group [50 μg/(kg·d)] and FA_h group[100 μg/(kg·d)]. Egg albumin was used to establish a food allergy model, with different doses of 1, 25(OH)₂D₃ for gastric intervention, and the control group was replaced by 9 g/L saline.The serum levels of ovalbumin-immunoglobulin E(OVA-IgE), interleukin(IL)-9 and IL-17 of mice were measured by using enzyme linked immunosorbent assay after the last excitation, and HE staining and histopathological examination were carried out in the small intestine of mice. Results: Compared with group C, FA₀ group and FA_h group small intestinal mucosa in mice had different degrees of damage, partial peeling off, structure disorder, villi epithelial cell focal falls peeling off, necrosis, lamina propria edema, congestion, a large number of inflammatory cells infiltration, low but the FA_l group and FA_m group had light mucosa damage, intestinal epithelial basically intact, with integrity, no congestion, edema, and inflammatory cells infiltration to a lesser degree.The mean concentrations of serum IgE, IL-9 and IL-17 in different groups were statistically significant (F=40.770, 9.530, 5.624, all P<0.05). Compared with the FA₀ group [(41.87±3.19) ng/L], the OVA-IgE of the FA_l group [(22.71±4.77) ng/L] and the FA_m group [(16.34±2.81) ng/L] were significantly reduced (t=5.533, 11.835, all P<0.01), but there was no significant difference between the FA_h group [(36.29±6.52) ng/L] (t=1.673, P>0.05). Compared with the FA₀ group [(161.77±50.44) ng/L], the IL-9 levels of the FA_l group [(94.29±18.79) ng/L] and the FA_m group[(84.45±30.88) ng/L] were significantly lower (t=3.267, 3.366, all P<0.01), while that of the FA_h group [(36.29±6.52) ng/L] was not significantly lower (t=0.777, P>0.05). Compared with FA₀ group [(81.55±29.37) ng/L], IL-17 levels of FA_h group [(133.58±47.05) ng/L] was significantly increased (t=2.653, P<0.05), while IL-17 level of FA_l group [(79.41±25.15) ng/L] and FA_m group [(58.81±26.00) ng/L] were lower than that of FA₀ group [(81.55±29.37) ng/L], but the difference was not statistically significant (t=0.154, 1.640, all P>0.05). Conclusions Low, medium dose of 1, 25(OH)₂D₃ supplements can inhibit mice food allergies, but high doses of 1, 25(OH)₂D₃ improve performance in mice food allergies, and 1, 25(OH)₂D₃′s influence on the secretion of IL-9 is one that influences mechanism of food allergy.