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.

Objective To explore the surgical features of retroperitoneoscopic excision of adrenal myelolipoma with diameter larger than 6 cm. Methods We retrospectively analyzed clinical data of 28 cases of giant adrenal myelolipoma from March 2010 to December 2015.The diameter of tumor was 6.0-13.7 cm (mean, 8.5 cm).There were 10 left-sided cases and 18 right-sided cases. During the retroperitoneoscopic excision of adrenal myelolipoma , four trocars were used .Two silk sutures were twisted as a loop to entangle one side of the tumor and then pulled it .Blood vessel on the surface of tumor was sealed and cut by ultrasonic scalpel . Adrenal gland was totally or partially removed and the tumor was resected completely . Results The operations were successful in all the 28 cases without hemorrhage during or after the surgery , conversion to open surgery , or injury of adjacent organs .The operation time was 52-117 min (mean, 67.5 min) and the blood loss was 45-110 ml during operation (mean, 60.5 ml).Patients took food 1-2 days after operation and ambulated 3-5 days after operation .The indwelling time of retroperitoneal drainage tube was 3-6 d (mean, 4.1 d).The postoperative hospitalization time was 6 -9 d (mean, 7.5 d). Conclusions Giant myelolipoma leads to seriously changed normal anatomy and is hard to be exposed during operation .Only when the important anatomical landmarks , large blood vessels and adrenal glands are focused , can the operation be safe and controllable .