For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

BACKGROUND:Local administration of anti-tuberculosis drugs is a commonly used therapy. Due to the rapid absorption, the drugs cannot have the durable therapy effect; therefore, it is necessary to seek an optimal carrier material for the agents. OBJECTIVE:To review the new development for the carrier materials of anti-tuberculosis drugs. METHODS:A computer-based search of PubMed and VIP databases was performed by the first author to search articles related to sustained-released anti-tuberculosis drugs published from January 1990 to December 2014. The key words were osteoarticular tuberculosis; anti-tuberculosis; sustained-released drugs in English and Chinese, respectively. RESULTS AND CONCLUSION:Inorganic materials (calcium phosphate, calcium sulfate), polymer materials (polylactic acid, polyglycolic acid, polylactic-co-glycolic acid) and biomaterials (protein, glutin, alginates, chitin, demineralized bone matrix) are the main three kinds of carrier materials for anti-tuberculosis drugs. These carrier materials have their own advantages and disadvantages, which cannot be the optimal carrier materials. However, the complex of these materials is a promising technology for the optimal carrier materials in the future.

[Objective]To investigate the morphological changes that take place in the subchondral cocortical bone in steroid-induced osteonecrosis and analyze the reasons leading to humeral head collapse in juvenile rabbits.[Method]Five-six month-old female rabbits were separated by two groups.A modified version of the methods was used to replicate steroid enhanced osteonecrosis anminal humeral head models with Shwartzman reaction in group A,and group B served as the single control.Each humeral head was obtained 10 weeks after the drugs injection.Subchondral cortical bone was observed,and the number of haversian canals was counted.The microcirculatory changes were also detected with scanning electron microscope.[Result]In group A,the Haversian canals in' subchondral area almost disappeared;the subchondral cortical bone disappeared with its arch,dome and bridge structures.Microcirculatory stasis happened in the subchondral vessels.Some humeral heads collapse were observed.While in group B,subchondral cortical bone is integrity and continuity,forming arch,dome and brige structures with subtrabecular bone.[Conclusion]The disappearance of the subchondral cortical bone is a major reason leading humeral head collapse,and ischemia is the critical reason of it.