Objective To investigate the distribution and infiltration characteristics of tissue-resident memory(TRM)cells in esophageal squamous cell carcinoma(ESCC),and further analyze relationship between TRM cell infiltration and ESCC immunotherapy and prognosis.Methods From January 2017 to December 2019,30 ESCC patients who did not receive preoperative neoadjuvant therapy in Xi'an Central Hospital were selected as focal tissue and para cancer tissue samples and peripheral venous blood samples.Immunofluorescence staining and flow cytometry were used to detect the distribution,expression infiltration of CD103+CD8+TRM cells and the expression of immune checkpoint molecules[Programmed death-1(PD-1)and T cell immunoglobulin and mucin domain 3(Tim-3)]in all samples.Another 86 ESCC patients who received neoadjuvant immune checkpoint PD-1 inhibitor treatment before surgery were selected during the same period,and the postoperative tissue samples were taken to detect the level of CD103+CD8+TRM cell infiltration,and the relationship between it and immunotherapy efficacy and prognosis was analyzed.Results The results of 30 ESCC patients who did not receive neoadjuvant therapy before surgery showed that:① CD103 was mainly localized in the cell membrane of tumor-infiltrating CD8+T lymphocytes.Most of the CD103+cells in ESCC cancer focus tissue co-express CD8+cells,while most of the CD103+cells in paracancer tissue did not co-express CD8+cells.②The proportion of CD103+CD8+TRM cells to CD8+T cells in ESCC cancer focus tissues was 76.9%±4.4%,which was significantly higher than that in adjacent normal tissues 65.8%±3.6%,and the difference was statistically significant(t=18.107,P＜0.001).③The proportion of CD103+CD8+TRM cells in ESCC tumor-infiltrating lymphocytes was 64.8%±4.3%,which was significantly higher than that in para-carcinoma infiltrating lymphocytes 34.6%±3.4%,the difference was statistically significant(t=30.175,P＜0.001),and peripheral blood lymphocytes were almost not expressed(1.1%±0.2%).④The immune checkpoint molecules PD-1 and Tim-3 were highly expressed in CD103+CD8+TRM cells of ESCC cancer foci.A sample of 86 ESCC patients treated with neoadjuvant immune checkpoint PD-1 inhibitors before surgery found that:① The proportion of CD103+CD8+TRM cell infiltration in the immunotherapy effective group was 76.5%±7.3%,which was significantly higher than that in immunotherapy ineffective group 58.7%±5.8%,the difference was statistically significant(t=12.126,P＜0.001).②The high infiltration group of CD103+CD8+TRM cells had higher OS survival than the low infiltration group,and the difference was statistically significant(Log-Rank χ2=2.635,P<0.05).Conclusion The expression and infiltration of CD103+CD8+TRM cells in ESCC tissues were higher than those in adjacent tissues,and the patients with high infiltration had better immunotherapy efficacy and survival prognosis,which could be used as a new biological indicator to provide a new reference for clinical prediction of the efficacy and prognosis of ESCC immunotherapy.

Objective To analyze the expression levels of long non-coding RNA(lncRNA)XIST and microRNA(miR)-186-5p in non-small cell lung cancer(NSCLC)tissues and their relationship with pathological features and prognosis.Methods From September 2020 to March 2022,92 NSCLC patients who underwent diagnosis and surgical treatment in our hospital were collected.Cancer tissues(study group)and adjacent tissues(control group)of NSCLC patients were collected during surgery,and real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)was employed to detect the expression levels of lncRNA XIST and miR-186-5p in both cancerous and adjacent non-cancerous tissues.A 2-year follow-up was conducted after surgery.NSCLC patients were separated into survival group and death group.Pearson method was applied to analyze the correlation between lncRNA XIST and miR-186-5p in cancer tissue.Cox regression was applied to analyze the factors affecting the prognosis of patients.Kaplan-Meier was applied to analyze the relationship between lncRNA XIST,miR-186-5p expression and prognosis in patients.Results The expression level of lncRNA XIST in cancer tissues of NSCLC patients was obviously higher than that in adjacent tissues(1.44±0.43 vs 1.03±0.16),and the expression level of miR-186-5p was obviously lower than that in adjacent tissues(0.76±0.18 vs 0.97±0.21)(P＜0.05).There was a targeted binding site between lncRNA XIST and miR-186-5p in cancer tissue of NSCLC patients,and their expression levels were negatively correlated(r=0.416,P＜0.05).TNM staging,lymph node metastasis,and degree of differentiation had a obvious impact on the expression of lncRNA XIST and miR-186-5p in NSCLC patients(P＜0.05).TNM staging,lymph node metastasis,degree of differentiation,and lncRNA XIST were risk factors for the prognosis of NSCLC patients.miR-186-5p was a protective factor for the prognosis of NSCLC patients(P＜0.05).The 2-year survival rate of NSCLC patients with low expression of lncRNA XIST(92.16％)was higher than that of high expression of lncRNA XIST(73.17％).The 2-year survival rate of NSCLC patients with high expression of miR-186-5p(91.23％)was higher than that of low expression of miR-186-5p(71.43％).Conclusion In cancer tissues of NSCLC patients,the expression level of lncRNA XIST is increased,while the expression level of miR-186-5p is reduced.lncRNA XIST and miR-186-5p are related to the prognosis of NSCLC patients.

Objective To analyze the expression levels of long non-coding RNA(lncRNA)XIST and microRNA(miR)-186-5p in non-small cell lung cancer(NSCLC)tissues and their relationship with pathological features and prognosis.Methods From September 2020 to March 2022,92 NSCLC patients who underwent diagnosis and surgical treatment in our hospital were collected.Cancer tissues(study group)and adjacent tissues(control group)of NSCLC patients were collected during surgery,and real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)was employed to detect the expression levels of lncRNA XIST and miR-186-5p in both cancerous and adjacent non-cancerous tissues.A 2-year follow-up was conducted after surgery.NSCLC patients were separated into survival group and death group.Pearson method was applied to analyze the correlation between lncRNA XIST and miR-186-5p in cancer tissue.Cox regression was applied to analyze the factors affecting the prognosis of patients.Kaplan-Meier was applied to analyze the relationship between lncRNA XIST,miR-186-5p expression and prognosis in patients.Results The expression level of lncRNA XIST in cancer tissues of NSCLC patients was obviously higher than that in adjacent tissues(1.44±0.43 vs 1.03±0.16),and the expression level of miR-186-5p was obviously lower than that in adjacent tissues(0.76±0.18 vs 0.97±0.21)(P＜0.05).There was a targeted binding site between lncRNA XIST and miR-186-5p in cancer tissue of NSCLC patients,and their expression levels were negatively correlated(r=0.416,P＜0.05).TNM staging,lymph node metastasis,and degree of differentiation had a obvious impact on the expression of lncRNA XIST and miR-186-5p in NSCLC patients(P＜0.05).TNM staging,lymph node metastasis,degree of differentiation,and lncRNA XIST were risk factors for the prognosis of NSCLC patients.miR-186-5p was a protective factor for the prognosis of NSCLC patients(P＜0.05).The 2-year survival rate of NSCLC patients with low expression of lncRNA XIST(92.16％)was higher than that of high expression of lncRNA XIST(73.17％).The 2-year survival rate of NSCLC patients with high expression of miR-186-5p(91.23％)was higher than that of low expression of miR-186-5p(71.43％).Conclusion In cancer tissues of NSCLC patients,the expression level of lncRNA XIST is increased,while the expression level of miR-186-5p is reduced.lncRNA XIST and miR-186-5p are related to the prognosis of NSCLC patients.

Objective To investigate the distribution and infiltration characteristics of tissue-resident memory(TRM)cells in esophageal squamous cell carcinoma(ESCC),and further analyze relationship between TRM cell infiltration and ESCC immunotherapy and prognosis.Methods From January 2017 to December 2019,30 ESCC patients who did not receive preoperative neoadjuvant therapy in Xi'an Central Hospital were selected as focal tissue and para cancer tissue samples and peripheral venous blood samples.Immunofluorescence staining and flow cytometry were used to detect the distribution,expression infiltration of CD103+CD8+TRM cells and the expression of immune checkpoint molecules[Programmed death-1(PD-1)and T cell immunoglobulin and mucin domain 3(Tim-3)]in all samples.Another 86 ESCC patients who received neoadjuvant immune checkpoint PD-1 inhibitor treatment before surgery were selected during the same period,and the postoperative tissue samples were taken to detect the level of CD103+CD8+TRM cell infiltration,and the relationship between it and immunotherapy efficacy and prognosis was analyzed.Results The results of 30 ESCC patients who did not receive neoadjuvant therapy before surgery showed that:① CD103 was mainly localized in the cell membrane of tumor-infiltrating CD8+T lymphocytes.Most of the CD103+cells in ESCC cancer focus tissue co-express CD8+cells,while most of the CD103+cells in paracancer tissue did not co-express CD8+cells.②The proportion of CD103+CD8+TRM cells to CD8+T cells in ESCC cancer focus tissues was 76.9%±4.4%,which was significantly higher than that in adjacent normal tissues 65.8%±3.6%,and the difference was statistically significant(t=18.107,P＜0.001).③The proportion of CD103+CD8+TRM cells in ESCC tumor-infiltrating lymphocytes was 64.8%±4.3%,which was significantly higher than that in para-carcinoma infiltrating lymphocytes 34.6%±3.4%,the difference was statistically significant(t=30.175,P＜0.001),and peripheral blood lymphocytes were almost not expressed(1.1%±0.2%).④The immune checkpoint molecules PD-1 and Tim-3 were highly expressed in CD103+CD8+TRM cells of ESCC cancer foci.A sample of 86 ESCC patients treated with neoadjuvant immune checkpoint PD-1 inhibitors before surgery found that:① The proportion of CD103+CD8+TRM cell infiltration in the immunotherapy effective group was 76.5%±7.3%,which was significantly higher than that in immunotherapy ineffective group 58.7%±5.8%,the difference was statistically significant(t=12.126,P＜0.001).②The high infiltration group of CD103+CD8+TRM cells had higher OS survival than the low infiltration group,and the difference was statistically significant(Log-Rank χ2=2.635,P<0.05).Conclusion The expression and infiltration of CD103+CD8+TRM cells in ESCC tissues were higher than those in adjacent tissues,and the patients with high infiltration had better immunotherapy efficacy and survival prognosis,which could be used as a new biological indicator to provide a new reference for clinical prediction of the efficacy and prognosis of ESCC immunotherapy.

Objective:To investigate the clinical effect of 3D printing combined with O-arm navigation assisted posterior hemivertebrae resection and orthopedic fixation in the treatment of congenital cervicothoracic scoliosis.Methods:A retrospective study was conducted on the clinical data of 14 patients with congenital cervicothoracic kyphosis caused by hemivertebra treated in Henan Provincial People's Hospital from January 2015 to June 2021, including 9 males and 5 females, aged 8.9±3.2 years (range, 1-15 years). Operation time, intraoperative blood loss and fusion stage were recorded. Intraoperative O-arm scanning and postoperative CT scanning were performed to evaluate the accuracy of nail placement. The cervicothoracic scoliosis Cobb angle, compensatory scoliosis Cobb angle, local kyphosis Cobb angle, torticollis angle, T 1 tilt angle and clavicular angle were measured before operation, model design, 1 week after operation and at the last follow-up to evaluate the effect of surgical design, intraoperative orthosis and the correction loss at follow-up. The Society for Scoliosis Research-22 (SRS-22) questionnaire was used to evaluate the functional and treatment effect. At the last follow-up, the osteotomy fusion was evaluated by Eck criterion. Results:All patients successfully completed the operation, the operation time was 228.5±41.8 min, the intraoperative blood loss was 355.6±46.7 ml, and the number of fusion segments was 5.5±0.8. Follow-up duration was 35.5±13.2 months. A total of 140 pedicle screws were inserted, with an accuracy of 97.1% (136/140). The Cobb angle of cervicothoracic scoliosis was 53.9°±17.9° preoperatively, 11.3°±4.4° in the model design, 10.8°±2.6° one week postoperatively, and 14.5°±3.5° at the last follow-up, with statistical significance ( P<0.001). The preoperative and postoperative one week difference was statistically significant ( P<0.001) with a correction rate of 78.6%±6.7%. The Cobb angle of compensatory scoliosis was 33.1°±12.1° before surgery, 11.9°±2.4° for model design, 10.5°±3.4° for one week after surgery, and 14.1°±2.5° for the last follow-up, with statistically significant differences ( P<0.001). The postoperative correction rate was 65.2%±16.2%. The Cobb angle of local kyphosis was 27.8°±9.8° preoperatively, 10.1°±2.1° in the model design, 9.8°±1.9° one week postoperatively, and 12.7°±1.6° at the last follow-up, with statistical significance ( P<0.001). The preoperative and postoperative one week difference was statistically significant ( P<0.001) with a correction rate of 59.2%±18.9%. The preoperative and postoperative one week difference was statistically significant ( P<0.001) with a correction rate of 78.6%±6.7%. The neck tilt angle was 20.6°±6.7° preoperatively, 6.2°±1.9° in the model design, 5.9°±2.1° one week postoperatively, and 7.1°±1.4° at the last follow-up, with statistical significance ( P<0.001). The preoperative and postoperative one week difference was statistically significant ( P<0.001) with a correction rate of 70.0%±11.1%. The T 1 inclination angle was 20.2°±5.8° preoperatively, 11.5°±3.1° in the model design, 10.2°±2.3° one week postoperatively, and 9.5°±3.0° at the last follow-up, with statistical significance ( P<0.001). The preoperative and postoperative one week difference was statistically significant ( P<0.001) with a correction rate of 53.2%±10.4%. There was no significant difference between preoperative design and actual measurement one week after surgery ( P>0.05). At the last follow-up, the scores of self-image (4.6±0.7), mental health (4.7±0.6) and treatment satisfaction (4.6±0.6)in SRS-22 scale were significantly improved compared with those before operation ( P<0.05). The symptoms of hemivertebra ipilateral C 8 nerve root injury occurred in 1 patient, who was treated conservatively with dehydration, hormones and nutraceutical drugs, and recovered to normal at 3 months follow-up. At the last follow-up, the appearance of the head, neck and shoulders of the patients was improved compared with that before surgery, the bone grafts have achieved osseous fusion in all patients. All fusion were grade I by Eck criterion. No complications such as serious neurological or vascular injury occurred during perioperative period. No pseudoarthrosis formation, internal fixation loosening or fracture occurred during follow-up. Conclusion:The application of 3D printing combined with O-arm navigation assistance technology in posterior hemivertebra resection and correctional surgery for cervicothoracic hemivertebra deformities can display the deformities in advance, stereoscopic and real-time, accurately place pedicle screws and complete hemivertebra resection, improve surgical safety and deformity correction rate.

Objective:To investigate the clinical efficacy of satellite rod revision surgery via a combined anterior and posterior approach for rod fracture after posterior vertebral column resection (PVCR) in patients with severe thoracolumbar kyphosis.Methods:A retrospective case series study was conducted on the clinical data of 11 patients with rod fracture after PVCR for severe thoracolumbar kyphosis, who were treated in Henan Provincial People′s Hospital from January 2013 to January 2021. There were 6 males and 5 females, with the age range of 21-62 years [(35.4±13.0)years]. Among them, 4 patients had traumatic kyphosis, 4 presented congenital kyphosis and 3 showed tuberculous kyphosis. All the patients had obvious low back pain. According to the American Spinal Injury Association (ASIA) score, 2 patients were found with grade C, 2 with grade D and 7 with grade E. All the patients underwent revision surgery for internal fixation using satellite rod via a combined anterior and posterior approach. The operation time, intraoperative blood loss and postoperative hospital stay were recorded. The imaging parameters such as kyphosis Cobb angle, scoliosis Cobb angle, distance between C 7 plumb line and central sacral vertical line (C 7-CSVL), and distance between C 7 plumb line and sagittal vertical axis (SVA) were measured preoperatively, at 1 week postoperatively and at latest follow-up. At the same time, the visual analogue scale (VAS), Oswestry dysfunction index (ODI), and simplified Chinese version of the scoliosis research society-22 (SRS-22) questionnaire were used to evaluate the clinical efficacy. At the latest follow-up, the osteotomy fusion was evaluated by Suk criterion and ASIA score was used to evaluate the recovery of neurological function. The complications were also recorded for the patients. Results:All the patients were followed up for 24-84 months [(47.5±16.2)months]. The operation time was 100-220 minutes [(149.4±37.6)minutes], with the intraoperative blood loss of 150-350 ml [(246.3±64.6)ml] and the postoperative hospital stay of 5-8 days [(6.1±1.1)days]. The kyphosis Cobb angles [(18.5±3.2)° and (19.3±2.9)°] and the scoliosis Cobb angles [(11.8±2.2)°, (11.1±2.2)°] at 1 week post-operation and at the latest follow-up were all improved significantly compared with the preoperative ones [(60.4±6.3)°, (21.7±5.5)°] (all P<0.01), with the average correction rates being 69.4% and 45.6%, respectively, with no significant differences between 1 week post-operation and latest follow-up (all P>0.05). The C 7-CSVL was reduced from preoperative (21.2±4.3)mm to (15.7±2.4)mm at 1 week post-operation, and to (15.9±2.2)mm at the latest follow-up (all P<0.01). The SVA was improved from preoperative (51.0±6.8)mm to (16.6±3.6)mm at 1 week post-operation, and to (15.3±3.9)mm at the latest follow-up (all P<0.01). There were no significant differences in C 7-CSVL or SVA at 1 week post-operation or at the latest follow-up (all P>0.05). The VAS [(2.5±0.9)points, (1.9±0.9)points], ODI (20.1±5.4, 18.4±5.2) and SRS-22 [(83.4±5.8)points, (85.0±4.1)points] at 1 week post-operation and at the latest follow-up were significantly improved compared with the preoperative ones [(6.0±1.4)points, 57.2±8.7, (62.0±9.1)points] (all P<0.01), but no significant differences were found between 1 week post-operation and latest follow-up (all P>0.05). At the latest follow-up, the bone grafts achieved osseous fusion in all the patients, and the ASIA grade was improved from grade C to grade D in 2 patients and from grade D to grade E in 2 patients. No complications such as serious neurological or vascular injury occurred during perioperative period. No pseudoarthrosis formation, internal fixation loosening or fracture occurred during follow-up. Conclusion:Satellite rod revision surgery via a combined anterior and posterior approach for rod fracture after PVCR in patients with severe thoracolumbar kyphosis has the advantages of less trauma and faster convalescence, excellent results of deformity correction, significant pain relief, functional improvement, and fewer complications.

Objective:To explore the clinical effect of the 3D printing pre-installed screw channel model in assisting screw placement of single complete segmented congenital hemivertebrectomy.Methods:Clinical data of 13 children treated with single complete segmented congenital hemivertebrectomy in the Department of Spine and Spinal Surgery of Henan Provincial People′s Hospital from August 2016 to January 2019 were retrospectively analyzed.Among them, there were 5 males and 8 females with the mean age of 9.9 (5-14) years.Categorized by the lesion location, 3 cases were located at T 9, 2 cases at T 10, 5 cases at T 11, 1 case at T 12, and 2 cases at L 1.During the operation, the 3D printing pre-installed screw channel model was used to assist the placement of pedicle screws.The accuracy of screw placement was assessed by the postoperative CT.All children were routinely examined by full-length anterior and lateral X-ray of spine in the standing position before and after surgery to measure the Cobb angles at the coronal and sagittal view.Furthermore, the correction rate of scoliosis and kyphosis after surgery and during follow-up was also calculated.The One-Way repeated measures ANOVA was used to compare the Cobb angle of scoliosis and kyphosis before surgery, after surgery and during follow-up. Results:A total of 85 pedicle screws were placed in 13 children, with the accuracy rate of screw placement of 95.3%.The mean surgery time and intraoperative blood loss were (216.9±28.3) min, and (478.5±132.6) mL, respectively.Scoliosis Cobb was corrected from (57.1±12.7)° to (12.7±4.7)° with a correction rate of (78.4±5.9)%, which was (14.2±7.0)° at the last follow-up.Kyphosis angle was corrected from (46.2±8.4)° to (13.2±4.4)° with a correction rate of (72.6±7.0)%, which was (14.0±3.4)° at the last follow-up.None of the children had serious complications like vascular and nerve damage.The mean postoperative follow-up was 12.3 (6-18) months.No significant loss of angle was detected during the follow-up period.There were significant differences in the lateral and kyphotic angles after surgery and during follow-up compared with preoperative ones (all P<0.05). No significant difference was detected between the postoperative lateral and kyphotic angles and those at the last follow-up (all P>0.05). Conclusion:The 3D printing pre-installed screw channel model used to assist screw placement of single complete segmented congenital hemivertebrectomy can improve the precision of screw placement and the orthopedic effect on lateral kyphosis.

Objective:To explore the accuracy and repeatability of the smartphone scoliosis screening APP developed by our team in the measurement of the Cobb angle of adolescent idiopathic scoliosis (AIS).Methods:Clinical data of 60 patients with AIS admitted to Department of Spine and Spinal Surgery, Henan Province People′s Hospital from August 2020 to February 2021 were analyzed retrospectively.Three surveyors measured the coronal main curvature Cobb angle, sagittal thoracic kyphosis (TK) angle, thoracolumbar kyphosis (TLK) angle and lumbar kyphosis (LL) angle on whole-spine lateral X-ray films of 60 patients with AIS by means of the protractor, scoliosis screening APP and computerized Picture Archiving and Communication System (PACS). The time and results of each measurement were recorded.The measurement was repeated once after 2 weeks.Paired t-test was used to compare the measurement time of the APP method and the protractor method.Taking the Cobb angle measurement results of the PACS system as the reference standard, the accuracy of Cobb angle measurement by the APP method was analyzed by paired t-test.The repeatability of the surveyor and the consistency between the surveyors was compared by intraclass correlation coefficient (ICC). Results:Among the 60 patients with AIS, there were 17 males and 43 females, aged from 10 to 16 years [(12.2±2.4) years]. The main bends were thoracic curvature (Lenke Ⅰ) in 23 cases, Lenke Ⅱ in 18 cases and thoracolumbar curvature/lumbar curvature (Lenke V) in 19 cases.The APP method took significantly less time to measure the Cobb angle than the protractor method ( P<0.05). There was no significant difference in the Cobb angle measured by the APP method and PACS method ( P>0.05). The results of the coronal main curvature Cobb angle, TK angle, TLK angle and LL angle measured by 3 surveyors through the APP method were all in good agreement (ICC=0.990, 0.988, 0.986, 0.987). The repeatability (ICC 0.973-0.982) of the coronal main curvature Cobb angle, TK, TLK and LL measured twice before and after the APP method were both better that of the protractor method (ICC 0.933-0.954). Conclusions:Compared with the traditional protractor, the smartphone scoliosis screening APP has the advantages of short measurement time, high efficiency, excellent accuracy and good repeatability in measuring the Cobb angle of AIS.

Objective:To analyze the postoperative paravertebral muscle degeneration and its correlations with health related quality of life (HRQL) in patients undergoing minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF).Methods:The clinical data of the 50 patients were retrospectively analyzed who had undergone single-segmental MIS-TLIF at Department of Spinal Cord Surgery, The People's Hospital of Henan Province from January 2019 to December 2021. The relative volumes of lumbar posterior muscle (LM), the relative volumes of the psoas major (PM), and the rates of fatty degeneration (FD) of the fused segment and its adjacent segments were compared respectively between preoperation, 6 and 12 months postoperation. The correlations were analyzed between the HRQL scores [visual analog scale (VAS) for pain and Oswestry disability index (ODI)] and the relative LM volumes, the relative PM volumes, and the FD rates of the fused segment and its adjacent segments at 12 months postoperation.Results:Compared with the preoperative values, the relative LM volumes and the relative PM volumes of the fused segment and its adjacent segments at 6 and 12 months postoperation were significantly reduced while the FD rates significantly increased. However, the FD rate of the fused segment at 12 months postoperation (20.6% ± 6.1%) was significantly lower than that at 6 months postoperation (29.7% ± 8.2%) ( P < 0.05). The VAS score was strongly negatively or positively correlated with the relative LM volume ( r = -0.819, P < 0.001) and the FD rate ( r = 0.86, P < 0.001) of the fused segment, and moderately negatively correlated with the relative PM volume ( r = -0.435, P = 0.016). The ODI index was moderately negatively correlated with the relative LM volume ( r = -0.512, P = 0.004) and the relative PM volume ( r = -0.402, P = 0.020) of the fused segment, but moderately positively correlated with the FD rate of the fused segment ( r = 0.565, P = 0.001). There was a moderate negative correlation between the ODI index and the relative LM volume of the adjacent segments ( r = -0.478, P = 0.012). Conclusions:After MIS-TLIF, the volume of the paravertebral muscles decreases and the dorsal muscles develop fatty degeneration. The improvement of LM fatty degeneration may be observed by 12-month follow-up in the fused segment, but not in the adjacent segments. The LM volume and the FD rate of the fused segment are the most closely related to the postoperative HRQL.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.