Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

With the technological progress and the unremitting efforts of spinal surgeons， minimally invasive lumbar spine surgery has developed rapidly in this century and has been widely recognized and used by patients and surgeons. However， there is a lack of standardized treatment guidelines for minimally invasive lumbar surgery. Varieties of surgical techniques and treatment strategies mainly rely on training and surgical experiences. This paper reviews the development of minimally invasive lumbar surgery and discusses the future challenges and technical direction in the development of minimally invasive lumbar surgery. We hope that more spinal surgeons can master minimally invasive spinal technology and make more patients benefit from it.

Objective:To investigate the perioperative risk factors of surgical site infection (SSI) of subaxial cervical spine injury after anterior surgery and provide a basis for the development of nursing measures.Methods:A retrospective case-control study was conducted to analyze the clinical data of 754 patients with subaxial cervical spine injury who underwent anterior surgery from January 2014 to January 2018, including 511 males and 243 females, aged 44-61 years [(50.2±5.1)years]. The fracture segment was C 3 in 60 patients, C 4 in 159, C 5 in 197, C 6 in 236 patients, and C 7 in 102. The patients were divided into two groups according to SSI occurrence. There were 28 patients in infected group and 726 patients in non-infected group. Data of the two groups were recorded, such as demographic data, American Spinal Injury Association (ASIA) scale, comorbidity, time interval from skin preparation to operation, preoperative urinary catheterization or not, consecutive operation or not, total number of staff involved in the operation, layer flow level of operating room, operating room temperature, relative humidity, operation duration, intern nurse involved in the operation or not and surgical methods. Univariate analysis was used to screen the indicators with statistically significant differences between the two groups. Multivariate Logistic regression analysis was further used to identify the risk factors of SSI. Results:The occurrence rate of SSI was 3.71% (28/754). The univariate analysis showed that there were significant differences between the two groups in ASIA scale, diabetes, dietary nursing, time interval from skin preparation to operation, preoperative urinary catheterization, consecutive operation, total number of staff involved in the operation, layer flow level of operating room and operation duration( P<0.01). The multivariate Logistic regression analysis showed that the ASIA scale (grade A: OR= 84.421, grade B: OR=27.200, P<0.01), diabetes ( OR=3.234, P<0.05), without diet nursing ( OR=2.375, P<0.05), time interval from skin preparation to operation ≥ 6 h ( OR=2.542, P<0.05), preoperative urinary catheterization ( OR=4.085, P<0.01), consecutive operation ( OR=2.894, P<0.05), total number of staff in the operating room ≥ 8 ( OR=3.137, P<0.01), layer flow level of operating room is grade 10, 000 or above ( OR=5.380, P<0.01) and operation duration≥ 3 h ( OR=2.405, P<0.05) were positively correlated with perioperative SSI. Conclusions:The factors associated with SSI of subaxial cervical spine injury after anterior surgery are the ASIA scale (grade A and B), diabetes, without diet nursing, time interval from skin preparation to operation ≥ 6 h, preoperative urinary catheterization, consecutive operation, total number of staff in the operating room ≥ 8, layer flow level of operating room (grade 10, 000 or above) and operation duration ≥3 h. For patients with subaxial cervical spine injury, attention should be paid to diet care, blood glucose monitoring should be strengthened, and operating room management should be optimized.

OBJECTIVETo explore the clinicopathologic features and imaging diagnosis of 17 cases of liposclerosing myxofibrous tumor (LSMFT) and to discuss the mechanism of the disease.

METHODSCases of LSMFT diagnosed in 2014 were included in this retrospective study. The clinicopathologic features and imaging findings were evaluated.

RESULTSThere were 17 cases of LSMFT, occurring in 11 men and 6 women with a mean age of 46 years (range, 26-67 years). Patients were asymptomatic or presented with pain localized over the lesions. Most (13/17) lesions were located in the intertrochanteric region. Radiographs showed well-defined and often extensively sclerotic margin. MRI showed the lesions to be relatively heterogeneous on T1W, and heterogeneous with high signal intensity on T2W with fat suppression. Microscopically, LSMFT was characterized by a complex mixture of histologic elements, including myxofibrous and collagen tissues, lipomatous areas, xanthoma cells, calcification, irregular ossification and pseudo-Paget's bone.

CONCLUSIONSLSMFT is a benign fibro-ossesous lesion with unique imaging characteristics and histologic features, occurring preferentially in some locations. It might represent end-stage degenerative changes in other benign bone lesions such as fibrous dysplasia, simple bone cyst and intraosseous lipoma secondary to trauma from forces and ischemic bone injury exerted on the intertrochanteric region of the femur.

Adult ; Aged ; Bone Neoplasms ; diagnosis ; pathology ; Calcinosis ; Female ; Femur ; pathology ; Fibroma ; diagnosis ; pathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies

Objective The aim of the experiment is to make an intracranial aneurysm model in canine.Methods A digital tube was made based on raw magnetic resonance images of the human intracraaial carotid artery.Then 6 tubes were made in the 3 D rapid prototyping machine and coated with silicone.Finally we isolated the common carotid arteries of 6 canines and made them go through the tubes and anastomosed them end-to-side to get the aneurysm model.Six stents were implanted after one week.Results Six aneurysm models were successfully made in canines.The parent artery had similar geometrv of the human carotid siphon.All the aneurysms and parent arteries were patent in one week's follow-up.One canine died of excessive anesthesia after stentingr Two vaseular models kept patent in one month without stenosis.The other 3 had some stenosis on the bends of the vessel.Conclusions The aneurysm model in tIle experiment has high flexibility and reliability.The model provides an effective tool for research and testing neurovascular devices.It's also a useful device to train the neuroradiologists and interventional physicians.