Objective To investigate the clinical efficacy of oblique lumbar interbody fusion(OLIF)combined with lateral plate fixation in the treatment of single-level adjacent segment disease(ASDis)following lumbar fusion surgery so as to evaluate the safety and effectiveness of this surgical approach.Methods A retrospective analysis was conducted on 46 patients with single-level ASDis after lumbar fusion surgery from August 2022 to October 2024.Twenty-three patients underwent OLIF combined with lateral plate fixation(OLIF group),while 23 patients received posterior lumbar interbody fusion(PLIF)(PLIF group).The following parameters were compared between the two groups:operative time,intraoperative blood loss,visual analogue scale(VAS)for pain,Oswestry disability index(ODI),disc height(DH),intervertebral foramen height(IFH),and interbody fusion status.Results All the 46 patients successfully completed surgery for single-level ASDis and were followed up for(13.7±1.1)months.The OLIF group had significantly shorter operative time[(70.7±4.6)min vs.(128.6±12.0)min]and less intraoperative blood loss[(58.6±5.7)mL vs.(313.3±47.5)mL]compared to the PLIF group(all P＜0.05).Both groups showed significant improvements in postoperative lumbar VAS and ODI scores at all follow-up time points compared to preoperative values(P＜0.05).The OLIF group exhibited significantly lower lumbar VAS scores at 3 days and 3 months postoperatively than those of the PLIF group(P＜0.05),and there was no statistical difference in VAS scores at the other follow-up time points(P＞0.05).There was no significant difference in postoperative ODI between OLIF group and PLIF group at each time point(P＞0.05).Postoperative DH and IFH were significantly improved in both groups compared to preoperative measurements(P＜0.05).In OLIF group,1 case of transient left thigh numbness resolved with conservative treatment within 2 weeks;1 case of cage subsidence was observed at 1 month postoperatively,achieving fusion without further displacement by 13 months.All the OLIF cases achieved complete fusion(fusion rate:100％).In PLIF group,2 cases of cerebrospinal fluid leakage healed with bed rest,1 case of wound exudation resolved with intensive dressing changes,and 1 case failed to achieve fusion(fusion rate:96％).Conclusion OLIF combined with lateral plate fixation demonstrates satisfactory early clinical outcomes for single-level ASDis after lumbar fusion,with significant advantages in operative efficiency(shorter time plus reduced blood loss)and short-term pain relief.Therefore,it is a safe and effective surgical approach.

Objective To investigate the clinical efficacy of oblique lumbar interbody fusion(OLIF)combined with lateral plate fixation in the treatment of single-level adjacent segment disease(ASDis)following lumbar fusion surgery so as to evaluate the safety and effectiveness of this surgical approach.Methods A retrospective analysis was conducted on 46 patients with single-level ASDis after lumbar fusion surgery from August 2022 to October 2024.Twenty-three patients underwent OLIF combined with lateral plate fixation(OLIF group),while 23 patients received posterior lumbar interbody fusion(PLIF)(PLIF group).The following parameters were compared between the two groups:operative time,intraoperative blood loss,visual analogue scale(VAS)for pain,Oswestry disability index(ODI),disc height(DH),intervertebral foramen height(IFH),and interbody fusion status.Results All the 46 patients successfully completed surgery for single-level ASDis and were followed up for(13.7±1.1)months.The OLIF group had significantly shorter operative time[(70.7±4.6)min vs.(128.6±12.0)min]and less intraoperative blood loss[(58.6±5.7)mL vs.(313.3±47.5)mL]compared to the PLIF group(all P＜0.05).Both groups showed significant improvements in postoperative lumbar VAS and ODI scores at all follow-up time points compared to preoperative values(P＜0.05).The OLIF group exhibited significantly lower lumbar VAS scores at 3 days and 3 months postoperatively than those of the PLIF group(P＜0.05),and there was no statistical difference in VAS scores at the other follow-up time points(P＞0.05).There was no significant difference in postoperative ODI between OLIF group and PLIF group at each time point(P＞0.05).Postoperative DH and IFH were significantly improved in both groups compared to preoperative measurements(P＜0.05).In OLIF group,1 case of transient left thigh numbness resolved with conservative treatment within 2 weeks;1 case of cage subsidence was observed at 1 month postoperatively,achieving fusion without further displacement by 13 months.All the OLIF cases achieved complete fusion(fusion rate:100％).In PLIF group,2 cases of cerebrospinal fluid leakage healed with bed rest,1 case of wound exudation resolved with intensive dressing changes,and 1 case failed to achieve fusion(fusion rate:96％).Conclusion OLIF combined with lateral plate fixation demonstrates satisfactory early clinical outcomes for single-level ASDis after lumbar fusion,with significant advantages in operative efficiency(shorter time plus reduced blood loss)and short-term pain relief.Therefore,it is a safe and effective surgical approach.

【Objective】 To compare the clinical efficacy of unilateral biportal endoscopic （UBE） and microscopic discectomy in the treatment of lumbar disc herniation （LDH） and to explore the safety and effectiveness of this operation. 【Methods】 A total of 87 LDH patients from July 2018 to July 2021 were analyzed retrospectively， including 42 cases of unilateral biportal endoscopic discectomy and 45 cases of microscopic discectomy. Analysis was based on comparison of perioperative metrics， operation time， and estimated blood loss. Clinical outcomes were evaluated using visual analogue scale （VAS）， Oswestry disability index （ODI） and modified Macnab criterion. 【Results】 All patients were followed up for 13.3±1.18 months. In UBE group， operation time （57.12±6.35） min was shorter than that in the microscope group （62.21±7.09） min and estimated blood loss （29.31±3.62） mL was smaller than that in the microscope group （51.77±8.43） mL， with a significant difference （P<0.05）. The two groups of patients had significantly lower back pain VAS score， leg pain VAS score， and ODI index than those before operation （P<0.05）. The VAS score of lower back pain at 3 days after operation and the ODI index at 1 month after operation were significantly lower in UBE group than in the microscope group （P<0.05）. At other time points， there was no significant difference in lower back pain VAS score， leg pain VAS score or ODI index （P>0.05）. Dural sac tear occurred in 2 cases in UBE group and 3 cases in the microscope group； the incidence was not statistically significant （P>0.05）. Modified MacNab criterion evaluation at the last follow-up showed that 32 cases were excellent in UBE group， 7 cases were good， and 3 cases were fair， with the excellent and good rate of 92.9% （39/42）. The microscope group was excellent in 31 cases， good in 10 cases， and fair in 4 cases， with the excellent and good rate of 91.1% （41/45）. 【Conclusion】 UBE for LDH has a satisfactory short-term clinical efficacy， with the advantages of less trauma， greater efficiency， clear vision， and large operating space. Both UBE and microscopic discectomy can achieve good clinical results in treating LDH， but the former has the advantages of less trauma， high efficiency， and quick postoperative recovery.

BACKGROUND:It has been a hotspot in the treatment of spinal fracture by minimaly invasive approach.Compare with open operation,minimaly invasive surgery has less trauma,less bleeding,less tissue damage and shorter hospital stay.But no clinical study focuses on the reduction effect of minimaly invasive percutaneous screw fixation and maintenance of vertebral height.OBJECTIVE:To compare the difference of minimaly invasive percutaneous screw combined with articular process bone grafting and simple screw fixation in the treatment of thoracolumbar fracture on maintaining vertebral height.METHODS:Clinical data of 79 patients with T11-L2 thoracolumbar fractures (AO type: A1,A2,A3,B1) wereretrospectively analyzed.Among them,41 cases were treated by percutaneous pedicle screw fixation combined with articular process bone grafting,while 38 cases were treated by percutaneous pedicle screw fixation,from January 2010 to September 2013.Perioperative indicators in the two groups,visual analogue scale scores,and Oswestry Disability Index before and after surgery,as wel as at final folow-up were compared between the two groups.The anterior and posterior of vertebral height,the recovery of Cobb's angle were evaluated.RESULTS AND CONCLUSION:The patients in the grafting group were folowed up for 4-36 months and those in the non-grafting group were folowed up for 5-30 months,there was no significant difference in the folow-up time between the two groups (P=0.25).The operation time,intraoperative blood loss,postoperative ambulation time and hospital stay showed no significant difference between the two groups (P＞0.05).The folow-up results showed that,no significant difference was found in visual analogue scale scores and Oswestry Disability Index between the two groups (P＞0.05).However,the anterior and posterior of vertebral height,the recovery of Cobb's angle in the grafting group were significantly better than that in the non-grafting group (P＜ 0.05).The short-term efficacy and security are similar between the two surgery methods in the treatment of thoracolumbar fracture.However,minimaly invasive percutaneous screw combined with articular process bone grafting shows great advantages in recovering and maintaining the long-term stability.