Objective:To explore the morbidity features and therapeutic outcomes of rejections in pediatric kidney transplantation (KT) recipients.Methods:Between January 2013 and June 2022, 360 children undergoing KT were recruited.The relevant clinical data were collected for examining the morbidity features and therapeutic outcomes of rejections.The serum levels of creatinine were compared among groups by non-parametric rank test.And Kaplan-Meier and Log-rank methods were employed for examining the incidence of rejection and comparing mortality-censored graft survival rates among patients with different times of rejection.Results:A total of 58 recipients had 82 incidents of rejection with a cumulative incidence of 6.3%, 9.2% and 11.3% at 3/6/12 months respectively.Among 50 incidents of biopsy-proved rejections, the types were T cell-mediated rejection [TCMR, 42.0%(21/50)], antibody-mediated rejection [20.0%(10/50), ABMR] and mixed rejection [38.0%(19/50)].Among 58 incidents of initial rejection, 69% had maintained graft function (MGF) and 31% impaired graft function (IGF) after anti-rejection regimens.Among 80.8%, 85.7% and 75% of recipients with clinical rejection, ABMR or borderline rejection while 36.4% in TCMR patients had MGF.Fifteen kidney allografts lost function in 58 recipients with rejection.Five-year death-censored graft survival was significantly lower in patients with two or more incidents of rejection (30.5%, 95% CI: 12.3%-75.4%) than in those without rejection (92.9%, 95% CI: 89.3%-96.6%) ( P<0.000 1) or with only one rejection (82.9%, 95% CI: 65.9%-100%)( P<0.001). Conclusions:The rejection rate remains high in KT children and it affects graft survival.And TCMR is more likely to cause impaired graft function.Recurrent rejections have a more pronounced impact upon graft survival.

ObjectiveTo explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines. MethodA total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups. On the basis of conventional western medicine treatment for hypertension， the control group （47 patients） was treated with Shugan Jieyu capsules for 8 weeks， while the treatment group （51 patients） with Gouteng prescription for 8 weeks. The two groups were compared in terms of the blood pressure level， 24-hour blood pressure variability， Hamilton anxiety scale （HAMA） score， Pittsburgh sleep quality index （PSQI） score， quality of life （SF-36 scale） score， traditional Chinese medicine （TCM） syndrome score and efficacy， incidence of adverse reactions， and the levels of interleukin （IL）-1β， IL-6， IL-10， and IL-4 in the serum of peripheral blood. ResultThe final trial was completed with 95 patients， including 46 in the control group and 49 in the observation group. The treatment in both groups lowered the blood pressure and blood pressure variability （P<0.05， P<0.01）. The observation group outperformed the control group in recovering the systolic blood pressure （SBP）， 24-hour mean systolic blood pressure （24 h SBP）， 24-hour systolic blood pressure variability （24 h SBPV）， and 24-hour diastolic blood pressure variability （24 h DBPV） （P<0.05）. After treatment， the HAMA and PSQI scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower HAMA and PSQI scores than the control group （P<0.05）. Compared with those before treatment， the SF-36 scores in both groups increased （P<0.05， P<0.01）. After treatment， the observation group had higher scores of physiological function （PF）， bodily pain （BP）， social function （SF）， role-emotional （RE）， and mental health （MH） indicators than the control group （P<0.05）. After treatment， the TCM syndrome scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower score than the control group （P<0.05）. The total response rate regarding TCM syndrome in the observation group was 85.71% （42/49）， which was higher than that （63.04%， 29/46） in the control group （χ²=6.621， P<0.05）. The treatment in both groups lowered the levels of pro-inflammatory cytokines （IL-1β， IL-6） and elevated the levels of anti-inflammatory cytokines （IL-10， IL-4） （P<0.05， P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.05）. There were no adverse events during the research process. ConclusionGouteng prescription can recover the blood pressure level， reduce blood pressure variability， suppress anxiety state， improve sleep and quality of life， decrease TCM syndrome score， increase total response rate， lower serum IL-1β and IL-6 levels， and elevate serum IL-10 and IL-4 levels in the patients with primary hypertension complicated with anxiety disorder due to yang hyperactivity and heat toxin. It may exert the effects by regulating the balance of pro-inflammatory and anti-inflammatory cytokines.

Objective:To investigate the effect of fat mass index (FMI) on early recovery after total knee arthroplasty (TKA).Methods:Patients who underwent primary unilateral TKA in Xi'an Honghui Hospital from July 2020 to July 2021 were retrospectively analyzed. The preoperative body composition was measured by dual energy X-ray absorptiometry and the FMI was calculated. Patients were divided into normal group (male: 3.0-6.0 kg/m 2; female: 5.0-9.0 kg/m 2), overweight group (male: 6.1-9.0 kg/m 2; female: 9.1-13.0 kg/m 2), and obese group (male: >9 kg/m 2; female: >13 kg/m 2) according to level of FMI, and the operation time, blood loss, and incidence of postoperative complications were collected. Multifactorial analysis of the effect of FMI on early recovery after TKA was performed using a generalized linear model. Draw the receiver operating characteristics (ROC) curve of BMI and FMI on the predicted effect of postoperative Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores and Knee Society Score (KSS) to compare the effect of FMI with BMI on early recovery after TKA. Results:A total of 100 patients were included in the study, 24 males and 76 females, aged 65.0±8.2 years (range, 42-81 years). There were 15 cases in normal group, 55 cases in overweight group and 30 cases in obese group. All patients successfully completed the operation and were followed up for 3.15±0.72 months (range, 2.8-3.2 months). The WOMAC scores of the obese group at 2 weeks, 1 and 2 months postoperative were 34.57±3.68, 22.03±2.79, and 15.77±2.96, which were greater than those of the normal group (28.73 ±2.58, 19.07±2.71, 12.27±3.10), as well as the overweight group (30.05±4.09, 19.33±2.42, 14.84±2.42), with statistically significant differences ( P<0.05). The KSS scores of the obese group at postoperative 1 and 2 months were 68.83±5.52 and 81.17±4.49, which were lower than those of the normal group (77.33±5.63, 87.33±4.17), as well as the overweight group (72.64±5.43, 83.73 ±5.02), with statistically significant differences ( P<0.05). The WOMAC score, KSS score, and postoperative complications at 2 months postoperatively were selected as outcome indicators to plot the ROC curve, and the ROC curve for the WOMAC score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.744 (95% CI: 0.54, 0.82), which was greater than that of BMI [0.624 (95% CI: 0.51, 0.74)], and the difference was statistically significant ( Z=2.19, P=0.021). The ROC curve for the KSS score at 2 months postoperatively showed an area under the curve corresponding to FMI of 0.718 (95% CI: 0.62, 0.82), which was greater than that of BMI [0.612 (95% CI: 0.52, 0.74)], with a statistically significant difference ( Z=2.58, P=0.016). The ROC curve for postoperative complications showed an area under the curve of 0.639 (95% CI: 0.41, 0.88) for FMI and 0.605 (95% CI: 0.37, 0.84) for BMI, with no statistically significant difference ( Z=0.48, P=0.632). Conclusion:The greater the FMI the poorer the early functional recovery after initial TKA, and FMI is more valuable than BMI in predicting the early functional recovery.

Objective:To investigate the feasibility and early clinical efficacy of spherical motion axis hinge knee prosthesis to reconstruct distal femoral bone defects.Methods:A retrospective analysis was performed on 16 patients admitted to PLA 960th Hospital and Tianjin Hospital from October 2019 to November 2021, including 8 males and 8 females, with an average age of 43.3±17.8 years (range, 15-71 years). There were 13 patients of primary tumors of the distal femur and 3 patients of postoperative revision of knee joint prostheses. Among the 13 patients with distal femur tumors, there were 6 cases of osteosarcoma, 5 cases of giant cell tumor of bone, 1 case of leiomyosarcoma and 1 case of chondrosarcoma. The reasons for revision after prosthesis replacement in 3 cases were: 2 cases of aseptic loosening after tumor-type prosthesis and 1 case of periphery fracture of surface artificial knee prosthesis. A spherical shaft rotary hinged knee prosthesis was designed and fabricated to reconstruct postoperative femoral defects in 16 patients. Follow up regularly after the operation, recheck the X-ray film to evaluate the lower limb force line, evaluate the quality of life after the operation with the Chinese version of 36-item short-form (SF-36), and evaluate the postoperative limb function with the Musculoskeletal Tumor Society (MSTS) 93 evaluation system.Results:All 16 patients were successfully placed with prostheses, and except for 2 patients undergoing total femoral replacement, the length of bone defects was 18.2±11.7 cm (range, 8.6-47.1 cm) in other 14 patients, and the operation time was 138±19 min (range, 110-170 min), the intraoperative blood loss was 211±118 ml (range, 100-500 ml). The postoperative full length orthostatic X-ray film of the lower limbs showed that the distance between the mechanical axis of the lower limb and the center of the knee joint was 0.1 (0, 0.7) cm in 16 patients, and the hip-knee ankle angle was 179.0°±2.3°(range, 173.3°-182.2°). The patients were followed up for 12-36 months. No prosthesis complications were found in 16 patients. The SF-36 score was 56.7±7.0 (range, 42.7-67.4) for physiological function and 54.1±7.6 (range, 40.5-66.3) for psychological function. The maximum knee flexion angle was 120.0°±15.6° (range, 95°-130°). The MSTS 93 score of 15 patients with tumor was 25.0±1.7 (range, 22-28), including 7 excellent and 8 good. One patient developed liver and lung metastases 10 months after surgery and died 18 months after surgery. The remaining patients, as of the last follow-up, were alive and had no local recurrence or distant metastases. Tumor-free survival time was 25.8±8.4 months (range, 12-36 months).Conclusion:The spherical motion axis hinge knee prosthesis reconstruction for distal femoral bone defects is simple and fast in intraoperative prosthesis installation, and there are no prosthetic related complications during short-term follow-up. The clinical efficacy is satisfactory.

Objective:To explore the ideal method of minimally invasive anterior lumbar extraperitoneal approach.Methods:Twenty-one adult embalmed cadavers underwent longitudinal incision near the left rectus abdominis, the extraperitoneal space and peritoneal characteristics were observed; the L 2-S 1 disc was exposed through extraperitoneal approach, and the relationship between the anterior large vessels and the disc was observed. One hundred adult abdominal CT were collected to measure the distance between the extraperitoneal fat of anterior abdominal wall and the rectus abdominis and the anterior midline at L 2-S 1 segment. One hundred and fifty adult lumbar MRI were collected to measure the distance between the anterior great vessels and the anterior midline of the intervertebral disc. Fifty-six cases of lumbar fusion were performed by minimally invasive anterior lumbar extraperitoneal approach, including 25 males and 31 females, aged 29-71 years. L 2-L 4 in 8 cases was performed by left rectus abdominis oblique incision, and L 4-S 1 in 48 cases was performed by median left transverse incision, with a length of about 8 cm, the complications related to the surgical approach were evaluated. Results:L 2-L 4 was proximal to the arcuate line, the posterior sheath of rectus abdominis adhered to the peritoneum, which was easy to rupture when separated; the peritoneum gradually thickened from the outer edge of the sheath of rectus abdominis and extraperitoneal fat appears. L 4-S 1 could be exposed distal to the arcuate line, the posterior side of rectus abdominis was extraperitoneal fat, the extension of arcuate line to the lateral abdominal wall would be slightly separated proximally, and there were multiple iliopsoas veins in the medial side of psoas major muscle. L 5S 1 was between the right common iliac artery and the left common iliac vein far, the median sacral vessel was small or absent, and the sympathetic nerve was to the left. Extraperitoneal fat appeared 36.2±9.9 mm, 35.2±11.6 mm and 27.6±11.2 mm away from the outer edge of rectus abdominis at L 2, 3, L 3, 4 and L 4, 5 segments respectively, and covered the posterior side of rectus abdominis and reached the midline at L 5S 1 segment. The left edge of abdominal aorta was 14.9±5.1 mm, 13.9±4.6 mm and 19.7±5.9 mm away from the midline at L 2, 3, L 3, 4 and L 4, 5 level respectively; the inferior vena cava was located on the right side of the midline at L 2, 3 and L 3, 4 level, crossed the midline 4.6±8.7 mm at L 4, 5 level. At L 5S 1 level, the left common iliac vein and the right common iliac artery were 14.6±6.8 mm and 17.6±5.3 mm away from the midline respectively. Seventy-six patients were successfully and fully exposed by small incision through extraperitoneal approach. 1 case of L 4, 5 had iliac lumbar vein tear and hemostasis with bipolar electrocoagulation. The operation time was 70-120 min, with an average of 90 min; Intraoperative bleeding was 15-70 ml, with an average of 30 ml. No severe complication such as nerve and great vessel injury occurred. Conclusion:Minimally invasive lumbar anterior retroperitoneal approach has small trauma and sufficient exposure with good feasibility. L 2-L 4 can be exposed with supine position and oblique incision next to the left rectus abdominis muscle, and L 4~S 1 with French position and median left transverse incision.

Objective:To evaluate the value and efficacy of microscope-assisted minimally invasive anterior lumbar discectomy and zero-profile fusion (ALDF) for lumbar degenerative diseases.Methods:Anterior lumbar distractors were designed to maintain the distraction of intervertebral space and expose the posterior edge of the intervertebral space. From June 2018 to December 2020, 41 cases of lumbar degenerative diseases were treated with this operation, including 19 men and 22 women, aged 29-71 years old (average 42.1 years old). All patients had intractable low back pain. Imaging examination showed lumbar disc degeneration with narrow intervertebral space, including disc herniation with Modic changes in 7 cases, spinal stenosis with instability in 16 cases and spondylolisthesis in 18 cases. The involved levels included L 2,3 in 1 case, L 3,4 in 3 cases, L 2-L 4 in 1 case, L 4,5 in 17 cases and L 5S 1 in 19 cases. An incision was taken that was pararectus for L 2-L 4 and transverse for L 4-S 1, with the intervertebral disc exposed via extraperitoneal approach. The intervertebral space was released and distracted after discectomy in intervertebral space, and self-made distractors were used to maintain the space. Under microscope, the herniation, posterior annulus and osteophyte were removed for sufficient decompression, with a suitable self-anchoring cage implanted into the intervertebral space. The visual analogue score (VAS), Oswestry dysfunction index (ODI), intervertebral space height, lordosis angle and spondylolisthesis rate were evaluated. Results:Operations were performed successfully in all the patients. The operation time was 70-120 min with an average of 90 min, and the intraoperative blood loss was 15-70 ml with an average of 30 ml. No severe complication such as nerve or blood vessel injury occurred. The patients were followed up for 12 to 36 months, with an average of 18 months. At the last follow-up, VAS decreased from 6.4±2.3 to 1.1±0.9, and ODI decreased from 44.9%±16.9% to 5.8%±4.7%. Intervertebral space height recovered from 7.2±2.8 mm to 12.1±2.1 mm and lordosis angle recovered from 6.9°±4.8° to 10.1°±4.6°. X-ray showed significant recovery of intervertebral space height, lordosis angle and spondylolisthesis rate, with obvious interbody fusion and no displacement of cage. For 18 patients of spondylolisthesis, the slippage recovered from 16.6%±9.3% to 7.6%±5.3%, with an average improvement of 54.2%.Conclusion:Microscope-assisted minimally invasive ALDF can provide sufficient decompression and zero-profile fusion for lumbar degenerative diseases with satisfactory results during short-term follow-up.

Objective:To evaluate the safety and validity of enriched autologous bone marrow mesenchymal stem cells (BMSCs) and annular suture for repairing defect after lumbar discectomy.Methods:Enrichment of autologous BMSCs: autologous bone marrow blood was collected from 5 patients undergoing lumbar surgery, and nucleated cells were enriched on gelatin sponge particles by selective cell retention technique. From October 2016 to March 2019, 109 patients with lumbar disc herniation underwent discectomy with mobile microendoscopic discectomy technique, including 61 males and 48 females, aged 24-59 years. Discectomy group: 26 cases received simple discectomy. Suture group: 39 cases received annular suture after discectomy. BMSCs+suture group: 44 cases received intradisc transplantation of gelatin sponge particles enriched with autologous BMSCs and annular suture after discectomy. The perioperative conditions were recorded, with visual analogue scale (VAS), Oswestry dysfunction index (ODI), Pfirrmann grade of disc degeneration, disc height and degree of herniationevaluated after operation.Results:In enrichment test with flow cytometry, the enrichment multiple of nucleated cells and target cells was 6.4±0.9 and 4.2±0.6 respectively, and BMSCs grew well in vitro. The operation time was 35-55 mins. 7 cases in the suture group were transferred to the discectomy group and 10 cases in the BMSCs+suture group were transferred to BMSCs group due to unsuccessful suture. There were no significant differences in VAS, ODI, Pfirrmann grade of disc degeneration, disc height and degree of herniation among the groups. There was no significant difference in intraoperative bleeding, postoperative drainage and length of hospital stay. The incision was healed without redness and swelling. 18 patients were followed up for 6 months, and 91 cases were followed up for 1-3 years (25.0±5.6 months). There was no interbody fusion, heterotopic ossification or infection during follow-up. VAS and ODI decreased significantly after operation in all patients. At final follow-up, the VAS improvement rate of BMSCs+suture group (81.7%±7.9%) was higher than discectomy group (73.0%±8.9%), suture group (74.0%±6.9%) and BMSCs group (75.3%±8.4%); the ODI improvement rate of BMSCs+suture group (91.9%±8.8%) was higher than discectomy group (86.2%±8.1%) and suture group (86.4%±5.5%). According to MRI, the Pfirrmann grade of disc increased 0.7 in discectomy group, 0.6 in suture group, while it did not increased significantly in BMSCs+suture group and BMSCs group, and the progress of Pfirrmann grade in BMSCs+suture group and BMSCs group were lighter than discectomy group and suture group.The disc height decreased in each group, the loss rate of disc height in BMSCs+suture group (17.2%±4.3%) was less than discectomy group (29.3%± 6.3%) and suture group (20.6%±5.7%); and suture group was less than discectomy group. The degree of herniation was reduced by more than 50% in all groups, while 1 case in discectomy group had herniation without clinical symptoms.Conclusion:Autologous BMSCs and annulus suture are safe and effective in repairing the defect after lumbar discectomy, which may help to slow down the degeneration of intervertebral disc.

Objective:To investigate the efficacy of biplane double-supported screw fixation in the treatment of femoral neck fractures in the middle-aged and young patients with the assistance of TiRobot.Methods:A retrospective analysis was conducted of the 28 young and middle-aged patients with femoral neck fracture who had been treated by biplane double-supported screw fixation at Department of Traumatic Orthopaedics, Puren Hospital from January 2021 to January 2022. According to the intraoperative use of TiRobot-assistance in the nail placement, they were divided into 2 even groups ( n=14). In the observation group where a TiRobot was used to assist nail placement, there were 6 males and 8 females, with an age of (44.1±8.7) years. In the control group where nail placement was monitored by conventional C-arm fluoroscopy, there were 7 males and 7 females, with an age of (48.8±8.0) years. The 2 groups were compared in terms of operation time, intraoperative fluoroscopy times, intraoperative blood loss, hospitalization time, fracture healing time, postoperative complications and hip function 6 months after operation. Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The operation time, intraoperative fluoroscopy times, intraoperative blood loss and hospitalization time in the observation group were significantly less than those in the control group [(66.5±3.7) min versus (77.1±3.9) min, (12.8±1.6) times versus (18.7±2.5) times, 3.5 (2.8, 4.0) mL versus 26.0 (24.0, 27.3) mL, (9.4±1.2) d versus (11.3±1.2) d] ( P< 0.05). During the follow-up period, the fractures healed well in both groups with no obvious complications. The fracture healing time in the observation group was (6.1±1.2) months, insignificantly shorter than that in the control group [(6.3±1.1) months] ( P>0.5). The Harris hip score 6 months after operation in the observation group (92.6±2.7) was significantly higher than that in the control group (90.6±1.9) ( P< 0.05). Conclusions:In the treatment of young and middle-aged patients with femoral neck fracture, the biplane double-supported screw fixation assisted by a TiRobot can shorten operation time and hospitalization time, and reduce the intraoperative fluoroscopy times and intraoperative blood loss for the patients, more conducive to the functional recovery of the hip joint, leading to better surgical efficacy than the nail placement monitored by conventional C-arm fluoroscopy.

Objective:To investigate the feasibility and clinical effects of thoracic endoscopic-assisted anterior-lateral decompression and fusion for thoracolumbar or upper lumbar disc herniation (LDH) associated with vertebral osteochondrosis (VO).Methods:From December 2017 to December 2019, 10 patients of thoracolumbar or upper LDH associated with VO were treated with thoracic endoscopic-assisted anterior-lateral decompression and fusion, including 6 men and 4 women, with an average 49.2 years old (range, 37 to 65 years old). The involved levels included T 12L 1 in 5 cases, L 1, 2 in 2 cases and L 2, 3 in 3 cases. There were 4 cases of simple thoracolumbar or upper LDH associated with VO and 6 cases of thoracolumbar or upper LDH associated with VO combined with ligamentum flavum hyperplasia and ossification or kyphosis (combined with posterior decompression and internal fixation or posterior correction surgery). The visual analogue scale (VAS), Oswestry disability index (ODI) and anterior and posterior height of intervertebral space were evaluated at follow-up. The clinical effects were evaluated according to the modified MacNab criteria. Results:The operation was performed successfully in all the patients. During the operation, the herniated disc and ossification were clearly exposed and completely removed, with the sufficient decompression of spinal cord, nerve root and dural sac. The operation duration was 115.4±23.8 minutes (range, 70 to 180 mins). Intraoperative bleed loss was 122.6±21.3 ml (range, 40 to 310 ml). The patients were followed up for averagely 21.6 months (range, 12 to 36 months). At the final follow-up, VAS score decreased from preoperative 7.2±1.9 to 1.8±1.1, and ODI decreased from preoperative 64.3%±13.9% to 16.3%±5.1% ( P<0.05). The anterior height of intervertebral space recovered from preoperative 7.8±1.5 mm to 11.9±2.3 mm, and the posterior height of intervertebral space recovered from preoperative 4.5±1.1 mm to 7.4±1.6 mm ( P<0.05). According to modified MacNab criteria, the results were excellent in 9 cases and good in 1 case. Conclusion:For thoracolumbar or upper LDH associated with VO, thoracic endoscopic-assisted anterior-lateral decompression and fusion provided clear vision of the surgical field, fully exposed and completely removed the herniated disc and ossification, which achieved satisfactory short-term results.

Objective:To summarize the clinical manifestations, epidemiological features and progress of diagnosis and treatment of gout in the spinal canal.Methods:A 59-year-old male patient was admitted to the hospital due to back pain, weakness in both lower limbs, hypoaesthesia and feeling of walking and stepping on cotton for more than one month. The preoperative imaging examination showed there were space-occupying lesions in the spinal canal at the T 8, 9 level with severe canal stenosis. The patient underwent posterior T 8, 9 laminectomy decompression, debridement and T 7-T 10 pedicle screw internal fixation under general anesthesia. The thoracic spinal gout was diagnosed by postoperative pathology. Further, the following keywords, "gout", "gout of spinal canal", "gout of spine" and "intraspinal gout", were used to search in the Chinese and English databases. A total of 62 patients with intraspinal gout were retrieved. The age, gender, involved disease, history of gout or hyperuricemia, laboratory indicators and imaging data of 63 patients were collected. Results:A total of 63 patients with intraspinal gout were retrieved. The gender of one patient was unknown. The remaining patients included 54 males (87.1%, 54/62) and 8 females (12.9%, 8/62) with the ratio of male to female 6.75∶1. The average age was 52(35, 67) years (range 20-82 years) and the peak onset period was 60-79 years. Fifty-six cases (88.9%, 56/63) of all patients suffered the disease from one single site of the spine, including 26 cases in the lumbar-sacral (46.4%), 22 cases (39.3%) in the thoracic spine and 8 cases (14.3%) in the cervical spine. However, only 7 patients had the disease at more than two sites at the same time accounting for 11.1% of all patients (7/63). Fifty-three patients (91.4%, 53/58) had a history of hyperuricemia with an average duration of 8.6 years (range 3 months to 28 years). The clinical symptoms of intraspinal gout were not specific. There were 70.5% (43/61) patients had local pain and up to 98.4% (60/61) patients had varying degrees of neurological dysfunction. X-ray examinations often showed no positive results due to technical limitations. Among 41 patients with CT imaging data, 31 cases showed mid-to-high density elliptical or irregular calcifications in the spinal canal and the remaining 10 patients showed medium-low density soft tissue masses. There were 96.2% (51/53) of patients with intraspinal gout showed medium or low signal on T1WI MRI examination but without high signal or low signal on T2WI (40 cases of high signal, 13 cases of high signal or mixed signal). All 63 patients were finally diagnosed by pathological examination and 5 of them with histological features. The main pathological features included foreign body granuloma, red-stained crystal-like deposits in the cytoplasm of foreign body giant cells, birefringent spindle or needle-like crystals under polarized light microscope.Conclusion:Gout in the spinal canal is a rare condition. Dual-energy CT has high sensitivity and specificity in identifying gout and it can provide a more accurate method in diagnosis of spinal gout. However, the final diagnosis depends on postoperative pathology. If case of spinal instability or neurological dysfunction, surgery had to be performed. Hyperuricemia should be treated in order to reduce the risk of acute attacks.