Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Objective To compare the clinical efficacy of the transforaminal endoscopic lumbar discectomy(TELD)approach with that of the interlaminar endoscopic lumbar discectomy(IELD)approach,both performed using a single-channel spinal endoscope,in the treatment of L4-L5 degenerative lumbar lateral recess stenosis(DLLRS).Methods A retrospective analysis was conducted on 78 patients with L4-L5 DLLRS who underwent single-channel endoscopic spinal surgery at our institution between March 2020 and March 2024.Patients were classified into the TELD group(lateral transforaminal approach,n=34)and the IELD group(interlaminar approach,n=44).Propensity score matching(PSM)was performed in a 1∶1 ratio using age,sex,body mass index(BMI),and duration of symptoms as covariates,yielding 25 matched pairs for final comparative analysis.Perioperative outcomes were systematically compared between groups.Visual analog scale(VAS)scores for low back pain and leg pain,as well as the Oswestry Disability Index(ODI),were evaluated preoperatively and at 3 days,3 months,6 months,and 1 year postoperatively.Lumbar computed tomography(CT)scans obtained 3 days after surgery were used to measure the lateral recess angle(LRA)and assess the extent of decompression.Spinal stability was evaluated using dynamic lumbar radiographs at 3 months postoperatively.Clinical outcomes were assessed 1 year after surgery based on the modified MacNab criteria.Results Both groups showed significant reductions in VAS scores for low back and leg pain,as well as in ODI scores,at all postoperative time points compared to baseline values(P<0.05).However,no statistically significant differences were observed between the two groups(P>0.05).Lumbar CT scans performed on postoperative day 3 demonstrated a significant increase in LRA in both groups relative to preoperative measurements(P<0.05).Although the magnitude of increase was greater in the IELD group,the intergroup difference did not reach statistical significance(P>0.05).At 3 months postoperatively,dynamic lumbar radiographs revealed no deterioration in spinal stability in either group compared to preoperative conditions,with no significant difference between groups(P>0.05).According to the modified MacNab criteria at 1 year postoperatively,the excellent and good outcome rate was 88.0%in the TELD group and 92.0%in the IELD group,with no statistically significant difference between the groups(P>0.05).Conclusions Both the TELD and IELD techniques are safe and effective for managing L4-L5 DLLRS,yielding comparable clini-cal outcomes.The selection of surgical approach should be guided by the anatomical location of ventral disc protru-sions,as well as the degree of facet joint hypertrophy and neural compression.

Objective To compare the clinical efficacy of the transforaminal endoscopic lumbar discectomy(TELD)approach with that of the interlaminar endoscopic lumbar discectomy(IELD)approach,both performed using a single-channel spinal endoscope,in the treatment of L4-L5 degenerative lumbar lateral recess stenosis(DLLRS).Methods A retrospective analysis was conducted on 78 patients with L4-L5 DLLRS who underwent single-channel endoscopic spinal surgery at our institution between March 2020 and March 2024.Patients were classified into the TELD group(lateral transforaminal approach,n=34)and the IELD group(interlaminar approach,n=44).Propensity score matching(PSM)was performed in a 1∶1 ratio using age,sex,body mass index(BMI),and duration of symptoms as covariates,yielding 25 matched pairs for final comparative analysis.Perioperative outcomes were systematically compared between groups.Visual analog scale(VAS)scores for low back pain and leg pain,as well as the Oswestry Disability Index(ODI),were evaluated preoperatively and at 3 days,3 months,6 months,and 1 year postoperatively.Lumbar computed tomography(CT)scans obtained 3 days after surgery were used to measure the lateral recess angle(LRA)and assess the extent of decompression.Spinal stability was evaluated using dynamic lumbar radiographs at 3 months postoperatively.Clinical outcomes were assessed 1 year after surgery based on the modified MacNab criteria.Results Both groups showed significant reductions in VAS scores for low back and leg pain,as well as in ODI scores,at all postoperative time points compared to baseline values(P<0.05).However,no statistically significant differences were observed between the two groups(P>0.05).Lumbar CT scans performed on postoperative day 3 demonstrated a significant increase in LRA in both groups relative to preoperative measurements(P<0.05).Although the magnitude of increase was greater in the IELD group,the intergroup difference did not reach statistical significance(P>0.05).At 3 months postoperatively,dynamic lumbar radiographs revealed no deterioration in spinal stability in either group compared to preoperative conditions,with no significant difference between groups(P>0.05).According to the modified MacNab criteria at 1 year postoperatively,the excellent and good outcome rate was 88.0%in the TELD group and 92.0%in the IELD group,with no statistically significant difference between the groups(P>0.05).Conclusions Both the TELD and IELD techniques are safe and effective for managing L4-L5 DLLRS,yielding comparable clini-cal outcomes.The selection of surgical approach should be guided by the anatomical location of ventral disc protru-sions,as well as the degree of facet joint hypertrophy and neural compression.

Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Objective To explore the origin of ovarian high grade serous carcinoma(HGSC) through analysing the expression and significance of PAX8,PAX2,p53 and RAS in the ovary and fallopian tube of different types and grades of serous carcinoma. Methods A total of 44 cases tissue samples of ovarian tumor including 34 malignant ovarian tumor and 10 normal normal tissue (as control group) were collected from the admitted patients in Affiliated Tumor Hospital of Guangxi Medical University from January 2015 to January 2016. Fallopian tube tissues were segmented in accordance with the fimbria, ampulla, isthmus and the corresponding ovarian tissues were by the side. There were 34 cases of patients with ovarian cancer including 29 cases of epithelial ovarian cancer (27 serous carcinoma, 1 mucinous carcinoma,1 endometrioid adenocarcinoma)and 5 non-epithelial ovarian cancer(sex cord-interstitial tumor). Among 27 cases of patients with ovarian serous cancer,there were 23 HGSC and 4 low-grade ovarian serous cancer (LGSC). One hundred fifty-three cases of samples were diagnosed as ovarian serous cancer by Shandong University Affiliated Qilu Hospital from 2005 to 2013 and these samples were made tissue microarray.(1)To analyze the expression and differences of PAX8,PAX2,p53 and RAS in the above tissues and tissue microarray from ovarian and tubal of HGSC and control women by immunohistochemistry methods.(2)To compare the expression levels of PAX8,PAX2,p53 and RAS in ovarian and fallopian tubes of ovarian cancer patients with different pathological types. (3) To analyze the correlations of tubal and ovarian tissue in PAX8,PAX2,p53 and RAS expression of HGSC.(4)To analyze the factors of the prognosis of ovarian serous cancer in tissue microarray by single factor analysis method. Results (1)PAX8,PAX2, p53 and RAS expression was negative in normal ovarian epithelium of control group,but the expression of PAX8, PAX2, p53 and RAS were strongly positive brown in secrete cells of normal fallopian tube epithelium.(2)p53 and RAS expression of fallopian tube epithelium in the epithelial ovarian cancer group were significantly higher than those in the non-epithelial ovarian cancer groups(P<0.05),but the expression of PAX8 and PAX2 in fallopian tube and the expression of PAX8,PAX2,p53 and RAS in ovarian tissue was not statistically significant in the groups(P>0.05).PAX8,PAX2 and p53 expression of the ovarian in HGSC group were significantly higher than those in LGSC group(P<0.05),while the expression of RAS was lower in the ovarian of the high-grade group (P<0.05), while the expression of PAX8, PAX2, p53 and RAS in fallopian tube was not statistically significant in the groups(P>0.05).(3)There was a significantly positive correlation between fallopian tube and the corresponding ovary of HGSC in PAX8 and PAX2 expression(r=0.422, P=0.045; r=0.693, P=0.000), but not correlation in p53 and RAS expression (r=0.058, P=0.793; r=-0.190,P=0.384).(4)Univariate survival analysis showed that the progression free survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8, PAX2 and RAS(P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and p53 protein expression (P>0.05). The total survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8 (P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and the protein expression of PAX2, RAS and p53 (P>0.05). Conclusions PAX8, PAX2, p53, RAS are of great significance for the study of origin of HGSC. HGSC may be derived from fallopian tube, but further investigation would be necessary to confirm this. PAX8, PAX2, p53, RAS could be expected to be used as predictors of survival prognosis in patients with ovarian serous cancer.