Objectives:To investigate the risk factors and treatment methods for distal junctional isthmic spondylolisthesis(DJIS)following posterior lumbar decompression and fixation surgery.Methods:The 10 patients who were treated at our hospital for DJIS following posterior decompression and fixation between January 2015 and January 2022 were retrospectively analyzed.The patients were included in the DJIS group,including 7 males and 3 females,aged 63.4±10.3(45-75)years old.And according to age,gender,preoperative diagnosis,operative stage,and operative method,the patients were matched in a ratio of 1∶2 with some other patients who didn't develop DJIS after underwent posterior decompression and fixation at our hospital due to lumbar degenerative diseases during the same period as control(20 cases).The general data[body mass index(BMI),L1 CT value,proportion of patients with osteoporosis)],laminectomy range of the lower vertebra(transverse decompression percentage of lamina,spinous process resection percentage),pelvic incidence(PI),and postoperative lumbar lordosis(LL),pelvic tilt(PT),sacral slope(SS),etc.of the two groups were compared to explore the risk factors for DJIS after posterior lumbar decompression and fixation.The treatment methods for DJIS were also summarized.Results:The BMI of patients in the DJIS group was significantly higher than that of the control group(27.4±4.1kg/m2 vs.23.7±3.4kg/m2,P＜0.001).The L1 vertebral CT value of the DJIS group was significantly lower than that of the control group(105.2±43.9HU vs.133.5±23.5HU,P=0.028),and the proportion of patients with osteoporosis of the DJIS group was higher(70％vs.10％,P=0.003).The DJIS group was greater in PI(52.5°±8.8° vs.45.8°±7.4°,P＜0.05)and postoperative LL(47.4°±14.3° vs.36.5°±10.6°,P＜0.05)significantly than the control group,PT and SS were not significantly different between the two groups(P＞0.05).Additionally,the transverse decompression percentage of lamina of the lower vertebra[(89.3±9.0)％vs.(78.0±3.2)％,P＜0.05]and the spinous process resection percentage of the distal vertebra[(51.1±16.1)％vs.(39.3±9.1)％,P＜0.05]in the DJIS group were also significantly higher than those in the control group.Eight DJIS patients underwent distal decompression,reduction,fixation,and fusion surgery,and their quality of life scores significantly improved after revision surgery.Two DJIS cases with mild clinical manifestations were treated conservatively,no symptom exacerbation was reported during follow-up.Conclusions:High BMI,osteoporosis,high PI,and excessive distal vertebral lamina resection during surgery are potential risk factors for DJIS after posterior lumbar decompression and fixation.

Objectives:To propose a method based on machine learning to predict the neurological function-al status of patients with traumatic cervical spinal cord injury(TCSCI).Methods:The clinical data of 180 pa-tients with TCSCI admitted to Shanghai Changzheng Hospital were retrospectively analyzed,including cervical spine MRI images and American Spinal Injury Association(ASIA)scores within 24 hours after injury and the ASIA scores at 1-year follow-up after injury.The 180 patients were randomly divided into a training set of 144 patients and a test set of 36 patients in a ratio of 8∶2.Overall,a new clinical-imaging prediction method was proposed using the two-stage integration concept,which used the ASIA scores and MRI images within 24 hours after TCSCI to achieve a full-feature prediction of the patient's sensory and motor function one year after injury.In the first stage,models such as GradentBoosting,GaussianNB,KNeighbors,Decision-Tree,RandomForest,and support vector classifier were used to independently predict the sensory-motor func-tion recovery of 132 skin nodes and muscle nodes.In the second stage,the optimal model for each feature prediction was screened out through horizontal and vertical comparison of performance indicators,so as to fi-nally achieve the best prognostic prediction of neurological function at 56 light touch and 56 acupuncture skin nodes,and 20 key muscle nodes.After the constructed prediction model is trained and verified,the pre-diction of the test set is evaluated using accuracy,precision,recall,average precision and F1 score.Results:In terms of the overall performance of this prediction model in predicting sensory-motor function in TCSCI patients 1 year after injury,all models in the test set achieved accuracy ≥0.886,recall ≥ 0.845,precision ≥0.875,average precision ≥0.853,and F1 score≥0.859,demonstrating that the correct prediction ability of each model and the quality and completeness of the actual prediction results were relatively high.Moreover,the two-stage prediction model can optimize the prediction effect of each model on each feature,and the prediction performance is better.Conclusions:This sensory-motor full-feature prediction method can effective-ly predict the neurological function recovery of TCSCI patients at 1-year follow-up after injury.Its predictive ability is significantly higher than that of a single model,and is expected to provide a useful reference for the personalized diagnosis,treatment and rehabilitation of TCSCI patients.

Objectives:To explore the effects of early regular rehabilitation exercise on lumbar function and saggital plane parameters of patients after single-segment posterior lumbar interbody fusion surgery(PLIF).Methods:Using a prospective,contemporaneous,parallel,controlled study design,124 patients who underwent single-segment PLIF for degenerative lumbar spine disease were randomly divided into a rehabilitation group and a control group,with 62 patients in each group.The rehabilitation group consisted of 30 males and 32 females,with a mean age of 54.0±4.8 years old;The control group included 29 males and 33 females,with a mean age of 55.0±5.2 years old.Patients in the rehabilitation group were instructed in regular functional training under the guidance of rehabilitation instructor,while patients in the control group performed function-al exercise on their own.The preoperative,postoperative 1,3,and 6 months'Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)score,and Barthel scale score were recorded.Drainage and hospitaliza-tion days were recorded,and lumbar lordosis(LL)angle and lumbar arch area(LAA)before operation and at postoperative 3 and 6 months were measured and compared between groups,perioperative complications were recorded,and finally a statistical analysis was performed to compare the differences in treatment effects between the two groups.Results:The ODI,JOA score and Barthel scale score of the rehabilitation group were better than those of the control group at 1 and 3 months after surgery,with statistical significance(P＜0.05).There were no significant differences in ODI,JOA score and Barthel score between the two groups at 6 months after operation(P＞0.05).There was no statistical difference in the amount of drainage between the two groups(P＞0.05).The number of hospitalization days in the rehabilitation group was less than that in the control group(7.6±0.7d vs 9.7±0.6d,P＜0.05).At 6 months postoperatively,the LL and LLA of patients in the rehabilitation group(51.3°±2.3° and 26.6±1.6mm2)were greater than those of patients in the control group(46.8°±4.2° and 21.5±3.1mm2),and the differences were statistically significant(P＜0.05).As for early postoperative complications,one case of abdominal distension and constipation and one case of hematoma in the operation area were observed in the rehabilitation group;Six cases of abdominal distension,two cases of deep vein thrombosis,one case of lung infection and one case of urinary tract infection were observed in the control group.There was no statistical difference in complications between the two groups(P＞0.05).Conclusions:After single-segment PLIF,early and regular rehabilitation training can shorten the length of hospital stays,reduce perioperative complications,and have a positive effect on the functional recovery and improvement of living ability of patients.

Objectives:To systematically compare the clinical efficacies of visualized endoscopic foramino-plasty and traditional foraminoplasty in the treatment of degenerative lumbar diseases.Methods:Literature of clinical comparative studies of visualized foraminoplasty(visualized group)and traditional foraminoplasty(tradi-tional group)in the treatment of lumbar degenerative diseases were searched from the databases such as CN-KI,VIP,WANFANG DATA,and PubMed from the inception to December 2023.The Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included retrospective case-control studies,and the Cochrane Risk of Bias Tool was used to assess the risk of bias in the included prospective randomized controlled stud-ies.The main efficacy indicators of the two groups[operative time,C-arm fluoroscopy frequency,hospitalization time,complications,visual analogue scale(VAS)score,and Oswestry disability index(ODI)]were statistically analyzed.RevMan 5.3 software was used for Meta-analysis of the literature that met the inclusion criteria.Results:A total of 4 prospective studies and 12 retrospective studies were included.The NOS evaluation in-dicated that the retrospective studies were of medium to high quality,and the Cochrane risk of bias assess-ment showed a low risk of bias in the prospective studies.A total of 1,239 patients were included,with 642 in the visualized group and 597 in the traditional group.Meta-analysis results showed that the the visualized group had fewer C-arm X-ray fluoroscopies(MD=-8.16,95％CI:-10.06--6.27,P＜0.001)and shorter operative time(MD=-17.18,95％CI:-21.48--12.88,P＜0.001)compared to the traditional group.There were no statisti-cally significant differences between the two groups in terms of hospitalization time,VAS score,ODI improve-ment,or postoperative complications(P＞0.05).Conclusions:Both visualized endoscopic foraminoplasty and tra-ditional endoscopic foraminoplasty can achieve good clinical efficacies in the treatment of degenerative lumbar diseases.However,visualized endoscopic foraminoplasty has shorter operative time and fewer C-arm fluoro-scopies compared to traditional endoscopic foraminoplasty.

Objectives:To evaluate the efficacies of laminoplasty(LP)and laminectomy and fusion(LF)in the treatment of multi-level ossification of the posterior longitudinal ligament(OPLL)in the cervical spine through meta-analysis.Methods:The databases of CNKI,Wanfang,Pubmed,Cochrane Library,EMBASE were searched by computer from their inceptions to June 2023 and the published clinical studies comparing LP and LF in the treatment of multi-level OPLL in the cervical spine were included.Cochrane risk bias assess-ment tool and Newcastle-Ottawa scale(NOS)were used to evaluate the quality of the included studies.Rele-vant data including operation time,intraoperative blood loss,the improvement rate of Japanese Orthopaedic Association(JOA)score,the change value of visual analogue scale(VAS)score,neck disability index(NDI),cer-vical curvature index(CCI),sagittal vertical axis(SVA)and cervical range of motion(CROM)at the final fol-low-up,the postoperative complication rate and OPLL progression rate were extracted and sorted.Then the meta-analysis was conducted by RevMan 5.4 and StataSE 16.0 softwares.Results:12 literatures(3 randomized controlled studies and 9 cohort studies)were ultimately included,involving a total sample size of 1496 cases,containing 839 cases in the LP group and 657 cases in the LF group.The results of meta-analysis were as follows:the LP group was better than LF group with significant differences in operation time[WMD=-28.01,95％CI(-36.25,-19.77),P＜0.00001],intraoperative blood loss[WMD=-115.09,95％CI(-197.91,-32.27),P=0.006],the change value of CROM[WMD=-7.83,95％CI(-8.10,-7.55),P＜0.00001]compared with those before surgery at final follow-up,the incidence of postoperative C5 nerve root paralysis[OR=0.32,95％CI(0.21,0.50),P＜0.00001]and axial symptoms[OR=0.44,95％CI(0.28,0.71),P=0.0006].The LF group was better than the LP group with significant differences in the change value of the CCI[WMD=-0.75,95％CI(-0.92,-0.58),P＜0.00001]and SVA[WMD=5.49,95％CI(5.30,5.68),P＜0.00001]compared with those before surgery at final follow-up,and the postoperative OPLL progression rate[OR=1.76,95％CI(1.26,2.46),P=0.0009].There were no significant differences between the two groups in the improvement rate of JOA score[WMD=-1.24,95％CI(-4.02,1.54),P=0.38],the change value of VAS[WMD=0.03,95％CI(-0.43,0.49),P=0.89]and NDI[WMD=0.54,95％CI(-0.07,1.14),P=0.08]compared with those before surgery at final follow-up,the incidence of postoperative cerebrospinal fluid leakage[OR=0.58,95％CI(0.24,1.39),P=0.22],incision infection[OR=0.71,95％CI(0.32,1.57),P=0.39]and epidural hematoma[OR=0.37,95％CI(0.06,2.16),P=0.27].Conclusions:Both LF and LP can effectively treat multi-level OPLL in the cervical spine and improve the neurological function of patients.Compared to LF,LP causes less surgical damage,preserves more cervical mobility and additionally,has a lower incidence of the postoperative C5 nerve root paralysis and axial symptoms.In comparison,LF can better maintain the curvature and stability of the cervical spine and delay the progression of ossification.

Objectives:To compare the biomechanical outcomes of six different screw reinforcement methods for posterior lumbar pedicle screw augmentation technique in osteoporotic vertebrae through finite element analysis,and provide a reference for the optimization and selection of internal fixation screws.Method:The lumbar CT scan data from seven males without lumbar pathologies or surgical history were obtained.Age:68.0±4.9 years(60-75),height:171.7±3.2cm(168-176),weight:63.6±3.2kg(59-68).Continuous thin-layer scanning was performed using a 64-slice spiral CT to obtain DICOM images.The L3 vertebral 3D models were reconstructed using Mimics 21.0 software,after optimizing for surface geometry in Geomagic Wrap 2021,seven models of screw were designed and assembled in SolidWorks 2023.Screws were categorized into seven groups based on reinforcement methods:Group A(Control group,no reinforcement),Group B(increasing thread outer diameter),Group C(decreasing pitch),Group D(decreasing the part of pitch contacted cortical bone),Group E(bone cement reinforcement),Group F(penetrating the opposite cortex),and Group G(cortical bone tra-jectory screws).49 finite element models(7 screw types × 7 vertebrae)were established.After material property assignments based on the data from prior research literature,the Static Structural Analysis module of Ansys Workbench 2023 was employed to simulate axial pull-out experiments on the seven established finite element models.The pull-out displacement under an axial tension of 1,200N and the maximum equivalent stress when the screw was damaged were analyzed.Intergroup comparisons employed one-way ANOVA,with indepen-dent-sample t-tests for experimental vs.control group comparisons.Results:The maximum displacements of Groups A-G were 0.142±0.029mm,0.138±0.031mm,0.144±0.032mm,0.139±0.027mm,0.119±0.024mm,0.126±0.028mm,0.040±0.007mm,respectively.No statistically significant differences were observed between Groups A to F(F=0.812,P=0.5489).Group G demonstrated a statistically significant difference compared to Group A(P＜0.001).The maximum equivalent stress of groups A-G were 264.0±7.6MPa,234.8±28.0MPa,245.5±17.5MPa,260.0±7.2MPa,279.7±14.3MPa,311.9±31.4MPa,432.6±87.5MPa.Compared with group A,group B decreased by 11.1％,and group C decreased by 7％,and the differences were statistically significan(P＜0.05);Group D wasn't significantly different from group A(P＞0.05);Compared with group A,groups E-G increased by 5.9％,18.1％and 63.9％,respectively,and the differences were statistically significant(P＜0.05).Conclusions:Differ-ent screw augmentation techniques demonstrated significantly different effects on axial pull-out strength.In-creasing the outer diameter of the screw or decreasing the total pitch will reduce the axial pull-out strength of the screw,and reducing the pitch in the cortical bone area has no obvious positive effect on increasing the holding force of screw.Bone cement reinforcement,increasing the screw length in penetrating contralateral cortical bone,and cortical bone trajectory screw can all significantly improve the axial anti-pullout effect of the screw,among which Cortical bone trajectory screw augmentation technique has the most significant effect.

Objectives:To explore the impact of Gli1(gioma-associated oncogene homolog)on nucleus pulposus cells(NPCs)and its role in the fibrotic changes of the nucleus within intervertebral discs.Methods:A rat tail intervertebral disc puncture model was established.Histological staining was used to evaluate the levels of intervertebral disc degeneration and fibrotic changes in the untreated(negative control,NC)group and the puncture(puncture-induced intervertebral disc degeneration,PIDD)group.Western blot was used to assess the expression levels of Gli1 protein in the tissues.Gli1 protein was engineered to overexpress by lentivirus in NPCs and verified.The experiment was divided into three groups:control(Blank),Gli1 overexpression(Lv-Gli1),and virus control(lv-Ctrl).Immunofluorescence and Western blot were used to detect the expression levels of fibrotic markers FAP and FSP-1.Adding Gli1 inhibitor GANT61,cellular experiment was grouped into control(blank),Gli1 overexpression(Lv-Gli1),Gli1 overexpression+GANT61(Lv-Gli1+GANT61),and Gli1 overexpression+DMSO(Lv-Gli1+DMSO).Western blot was used to detect the expression levels of FAP and FSP-1 proteins.In vivo animal experiments were conducted in groups of puncture(PIDD),puncture treatment(PIDD+GANT61),and treatment control(PIDD+DMSO).Histological staining was used to evaluate the levels of intervertebral disc degeneration and fibrotic changes.Results:Histological staining results showed the histological score of degenerated discs significantly increased(P＜0.01).Western blot results showed a significant increase in Gli1 protein expression in the degenerated group(P＜0.05),which was consistent with the conclusions of the cellular experiments.NPCs overexpressing Gli1 protein were constructed,and immunofluorescence staining results showed that the expression of FAP and FSP-1 in the Gli1 overexpression group was significantly upregulated compared to the control and virus control groups.Western blot results further showed a significant increase in the expression of fibrotic markers in the Gli1 overexpression group(P＜0.05).In the Gli1 overexpression+GANT61 group of the cellular experiment,compared to the control and Gli1 overexpression groups,Western blot indicated that the expressions of FAP and FSP-1 proteins were downregulated(P＜0.05).In the in vivo experiment,the PIDD+GANT61 group showed a significant improvement in histological scores and collagen composition(P＜0.05).Conclusions:The expression of Gli1 protein is significantly upregulated in degenerated nucleus pulposus tissue and NPCs;Inhibition of Gli1 gene expression downregulates the expressions of FAP and FSP-1 proteins.The mechanism of intervertebral disc fibrosis and degeneration may be associated with the activation of Gli1.

Objectives:To analyze the 3D structural characteristics and discuss the clinical significance of pedicle-isthmus complex(PIC)through measuring the anatomical and morphological parameters of normal axis PIC.Methods:The imaging data of 100 patients without high-riding vertebral artery[57 males,43 females,56.1±1.8(18-79)years]undergone CT angiography(CTA)examinations of the cervical spine or neck and admitted to the Affiliated Hospital of Southwest Medical University between January 2022 and December 2022,and another 28 patients[15 males,13 females,55.5±14.6(18-80)years]undergone posterior C2 pedicle screw fixation and examined with CT scan of the cervical spine during the same period were collected.The original CT data were uploaded to Mimics 21.0 software,and bilateral PICs were segmented from the axis to construct a new coordinate axes with multiplanar reconstruction(MPR)technology.The upper,middle and lower faults of the PIC were cut on the new axes,and the front-most,narrowest and back-most parts of the PIC were determined.The widths of the front-most,narrowest and,back-most parts and inclination angles of the upper,middle and lower faults of PIC were measured on 3D images.Based on whether the PIC was punctured or not,the patients implanted with posterior C2 pedicle screws were divided into punctured group and non-punctured group.Using the axis pedicle screw as reference,the image parameters of screw position were measured,including the height from the screw midpoint to the PIC upper wall,the width of the screw midpoint to the PIC inner wall,and the screw inclination angle.Results:There was no statistical difference between the left and right side of PIC parameters in 100 patients.The width of PIC in males was greater than that in females at all levels,and the difference was statistically significant(P＜0.05).The results of PIC width from a coronal perspective showed that the overall width of the upper layer was 9.6±1.3mm,the overall width of the middle layer was 9.5±1.4mm,and the overall width of the lower layer was 8.0±1.1mm.There was no statistical difference between the overall width of the upper layer and the middle layer(P=0.41),while the difference between the other layers was statistically significant(P＜0.05).The overall width of the PIC from the cross-sectional perspective showed that the overall width of the front-most part was 8.8±1.4mm,the overall width of the narrowest part was 7.2±1.3mm,and the overall width of the back-most part was 11.0±1.5mm,with statistical significance among all layers(P＜0.05).The results of PIC inclination showed that the upper layer inclination was 15.1°±8.7°,the middle layer inclination was 19.5°±8.4°,and the lower layer inclination was 26.3°±9.0°,and the differences among all layers were statistically significant(P＜0.05).In the 28 patients fixed with posterior C2 pedicle screw,a total of 50 screws were inserted,with 25 screws each in the punctured group and non-punctured group.The distances from the screw midpoint to PIC upper wall[4.4(3.6-5.3)mm]and PIC inner wall[3.3(2.8-3.8)mm]in the non-punctured group was smaller than those in the punctured group[5.1(4.5-6.0)mm and 4.0(3.1-5.4)mm,P＜0.05].No statistical differences was found between the two groups in the screw inclination angles[17.6°(10.5°-21.5°)vs 16.9°(9.6°-23.1°),P=0.854].Conclusions:The normal PIC without high riding vertebral artery is wide at top and narrow at bottom in the coronal view,and wide at front and back and thin in the middle in the transverse view.The gradual increase of the internal inclination angle from top to bottom indicates that the 3D structure of PIC is distorted.Analyzing the axis PIC as a whole is helpful to better understand its anatomical morphology and change characteristics,and to guide the selection of safe strategies in implanting axial pedicle screws.

Objectives:To evaluate the clinical efficacies of robot-assisted versus C-arm fluoroscopy-guided percutaneous pedicle screw fixation for thoracolumbar burst fractures.Methods:A retrospective analysis was conducted on 46 patients(26 males,20 females;age 27-69 years)with thoracolumbar burst fractures treated between January 2022 and December 2023.The patients were divided into the observation group of 21 cases(12 males,9 females;52.1±8.8 years)receiving robot-assisted navigation,and the control group of 25 cases(14 males,11 females;50.9±13.2 years)undergoing conventional C-arm fluoroscopy guidance.No significant differences were observed in baseline characteristics(case number,sex ratio,BMI;P＞0.05).Both groups of patients underwent percutaneous pedicle screw internal fixation of the injured vertebra.Intraoperative parameters(fluoroscopy frequency,operative time,blood loss),postoperative CT scans on 3d(assessed by Gertzbein-Robbins scale for screw placement accuracy),pre-and postoperative pain VAS scores(thoracolumbar back pain before surgery and at 1d,3d,and 1 month after surgery),and radiographic parameters(Cobb angle,anterior vertebral body height ratio at preoperation,and postoperative 3d,1 month,and 6 months)were recorded and compared using t-tests and Mann-Whitney U tests.Results:The observation group demonstrated significantly shorter operative time(90.71±9.52min vs 117.62±16.63min,P＜0.05),reduced blood loss(67.14±18.75mL vs 139.52±28.01mL,P＜0.05),and fewer fluoroscopy exposures(9.14±2.27 vs 18.86±2.86,P＜0.05)than the control group.No complications occurred during follow-up in both groups.The observation group exhibited superior screw placement accuracy(98.4％vs 90.7％,P＜0.05)with 124/126 screws graded as excellent/good versus 136/150 in controls.Postoperative pain VAS scores were lower in the observation group on 1d(2.67±0.57 vs 4.00±0.70,P＜0.05)and 3d(1.19±0.68 vs 1.95±0.59,P＜0.05),but comparable at 1 month(0.76±0.43 vs 1.10±0.53,P＞0.05).The postoperative 3d,1 month and 6 months'Cobb angles(6.08°±1.49° vs 6.09°±1.05°,6.26°±1.46° vs 6.28°±1.14°,6.78°±1.38° vs 6.91°±1.31°)and anterior vertebral height ratios[(90.14±1.56)％vs(90.06±1.69)％,(89.62±1.56)％vs(89.44±2.12)％,(88.87±1.72)％vs(88.92±1.88)％]showed no significant in-tergroup differences at different time points(P＞0.05).Conclusions:Robot-assisted percutaneous pedicle screw fixation for the treatment of thoracolumbar burst fractures has significant advantages in improving surgical ac-curacy,reducing intraoperative blood loss,shortening operative time,and decreasing the number of fluoroscopic exposures.

Objectives:To explore the clinical efficacy and the postoperative recurrence rate of the vertebral"Collapse"lesion resection for treating thoracolumbar spinal metastases compared to separation surgery.Methods:A retrospective study was conducted on 78 patients with thoracolumbar spinal metastases treated at Tianjin University General Hospital from December 2018 to December 2022.There were 42 males(53.8％)and 36 females(46.2％),with a mean age of 61.9±10.6 years(range 34-76 years).The patients were divided into separation surgery group(21 cases)and"Collapse"resection group(57 cases).Two to three weeks after surgery,radiotherapy,chemotherapy or targeted drugs were given according to the type of primary tumor after wound healing.The data on operative time,intraoperative blood loss,drainage volume,Frankel classification for spinal cord injury,and visual analogue scale(VAS)scores for pain preoperatively,7d after operation and at final follow-up,as well as local recurrence rates and perioperative complications were collected.Results:The operative time and intraoperative blood loss in the"Collapse"resection group(328.7±89.2min,782.5±89.2mL)were significantly higher than those in the separation surgery group(243.2±89.2min,585.7±89.2mL)(P＜0.05).There was no statistically significant difference in postoperative drainage volume between the two groups("Collapse"resection group 698.2±230.2mL vs separation surgery group 674.7±180.7mL)(P＞0.05).During follow-up,all the patients in the separation surgery group received stereotactic radiotherapy postoperatively;While 10 patients(21.2％)in the"Collapse"resection group underwent radiotherapy,and the remaining 47(78.8％)patients received targeted,immunological,or chemotherapy as part of comprehensive treatment.The recurrence rate in the separation surgery group was approximately 9.5％(2/21).Among the patients who received"Collapse"resection plus radiotherapy,there was 1 local recurrence,resulting in a recurrence rate of 10％(1/10),while the patients who didn't receive radiotherapy experienced 3 local recurrences,with a recurrence rate of 6.4％(3/47).The overall recurrence rate for patients in the"Collapse"resection group was 7.0％(4/57).There was no statistically significant difference in recurrence rates between the two surgical procedures(P=0.708).In the separation surgery group,postoperative complications included one case of wound infection,one case of wound dehiscence two months after postoperative radiotherapy,and one case of epidural hematoma causing compression.In the group of"Collapse"resection,complications included one case of cerebrospinal fluid leakage with secondary infection and one case of superficial wound infection.VAS scores on 7d postoperatively significantly decreased compared to preoperative scores in both groups(P＜0.05),and there were significant differences in VAS scores at final follow-up compared to preoperative scores(P＜0.05).No statistical difference in VAS scores was observed between the two groups on 7d postoperatively and at final follow-up(P＞0.05).Except for 5 Frankel A-D grade patients with no significant improvement in neurological function,the remaining 73 patients showed no deterioration in neurological function,with varying degrees of recovery of at least 1 grade,yielding an improvement rate of 93.6％(73/78).Conclusions:The vertebral"Collapse"resection for thoracolumbar spinal tumors does not require postoperative radiotherapy,as the tumor recurrence rate is comparable to that of patients treated with separation surgery followed by radiotherapy.