Comparison of spinal anesthesia and local anesthesia in percutaneous interlaminar endoscopic lumbar discectomy for L5/S1 disc herniation: a retrospective cohort study.

BACKGROUND: Interlaminar endoscopic lumbar discectomy (IELD) is a prevalent method for managing lumbar disc herniation. Local anesthesia (LA) is frequently employed during IELD, albeit with its merits and drawbacks. The spinal anesthesia (SA) represents a feasible anesthetic strategy for IELD; however, the availability of clinical research data is currently limited. METHODS: The propensity score matching was conducted to ensure the comparability of the SA and LA groups. The outcome measures were operation time, intraoperative visual analogue scale (VAS) for pain, need for adjuvant analgesia, intraoperative vital signs, blood loss, adverse surgical events, anesthesia-related complications, postoperative bed rest duration, VAS for pain at 2 h postoperatively, Oswestry Disability Index score (ODI), satisfaction with surgical efficacy, and willingness to undergo reoperation at 6 months postoperatively. RESULTS: Fifty-six patients were assigned to each group. Significant differences were found between the groups regarding intraoperative VAS for pain, use of adjuvant analgesics, willingness to undergo reoperation, maximum intraoperative systolic blood pressure, and variability (P < 0.05). Compared to the LA group, the SA group had lower VAS for pain at 2 h postoperatively, a longer operation time, a longer duration of postoperative bedrest, and more anesthesia-related complications (P < 0.05). No significant intergroup differences were detected in intraoperative heart rate variability, blood loss, ODI, satisfaction with surgical efficacy, and surgery-related complications (P > 0.05). CONCLUSION: SA as an alternative anesthesia for IELD surgery holds great promise, exhibiting superior efficacy compared to LA. However, it is crucial to meticulously evaluate the indications due to potential risks associated with this form of anesthesia.

Point-of-care ultrasound detection of anterior inferior iliac spine avulsion fracture in an adolescent: A case report.

Purpose: This study presents a rare case of avulsion fracture of the anterior inferior iliac spine, typically occurring in adolescents engaged in physical activities. The purpose of this study is to emphasize the diagnostic challenges and conservative treatment options available for this condition. Method: We describe the case of a 14-year-old healthy adolescent who suffered from an avulsion fracture following pelvic trauma after participating in a short-distance sprint. Initial physical examination and X-ray imaging were inconclusive, showing no apparent fractures. Due to parental refusal of a Computerized Tomography (CT) scan by concerns over the potential risks associated with radiation exposure, a diagnostic ultrasound was performed, which confirmed the presence of an avulsion fracture at the anterior inferior iliac spine. Results: The ultrasound findings led to a conservative treatment approach, involving rest, and unloading of the affected limb. Follow-up assessments indicated significant pain relief within four weeks and enabled the resumption of partial physical activity after six months. Conclusion: This case highlights the utility of ultrasound as an effective alternative diagnostic tool in situations where CT scans are not permissible. Additionally, it demonstrates that conservative management can be successful in treating avulsion fractures of the anterior inferior iliac spine in adolescents, leading to satisfactory recovery and return to activity.

Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.

PURPOSE: The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF). METHODS: The clinical outcomes were assessed, and intraoperative data and complications were collected. Numeric Rating Scale (NRS) scores for low back pain and leg pain, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores for evaluating functions of the lumbar spine and health-related quality of life, and the modified MacNab standard for assessing satisfaction were analyzed. Radiographic outcomes included disc space height, segmental lordosis, interbody fusion assessment, and the rate of muscle atrophy of the multifidus and the erector spinae muscles. RESULTS: Among the three groups, the SPSW group exhibited the shortest operation and drain retention time, lowest intraoperative blood loss, and minimal postoperative blood loss. Notably, the SPSW group displayed the highest level of social life function based on the JOABPEQ, and the highest level of patient satisfaction according to the modified MacNab Criteria, along with the lowest rate of muscle atrophy. CONCLUSION: All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.

Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study.

OBJECTIVE: The reported date in the repeat surgical intervention for adolescent lumbar disc herniation (ALDH) after percutaneous endoscopic lumbar discectomy (PELD) was quite scarce. This study aims to introduce cases of repeat surgeries after PELD for ALDH and assess the incidence, chief causes, repeat surgery methods, and surgical outcomes of repeat surgeries after PELD for ALDH. METHODS: A retrospective multicenter observational study was conducted on patients undergoing repeat surgeries after PELD for ALDH at four tertiary referral hospitals from January 2014 through August 2022. The incidence of repeat surgeries, chief causes, strategies for repeat surgeries, and timing of repeat surgeries were recorded and analyzed. The clinical outcomes were evaluated by the Numeric Rating Scales (NRS) scores and the modified MacNab criteria. Statistical analyses were performed with the Wilcoxon signed-rank test. RESULTS: A total of 23 patients who underwent repeat surgeries after PELD for ALDH were included. The chief causes were re-herniation (homo-lateral re-herniation at the same level, new disc herniation of adjacent level). The repeat surgery methods were revision PELD, micro-endoscopic discectomy (MED), open discectomy and instrumented lumbar inter-body fusion. The NRS scores decreased significantly in follow-up evaluations and these scores demonstrated significant improvement at the last follow-up (p < 0.002). For the modified MacNab criteria, at the last follow-up, 18 patients (78.26%) had an excellent outcome, and the overall success rate was 86.95%. CONCLUSION: This study's data suggest that young patients who underwent repeat surgery improved significantly compared to baseline. The chief cause was re-herniation. Revision PELD was the main surgical procedure, which provides satisfactory clinical results in young patients who underwent repeat surgeries.

A Rapid On-Line Evaluation (ROLE) Protocol in the Diagnostic Performance Improvement in Endoscopic Ultrasound-Guided Tissue Acquisition for Solid Pancreatic Lesions.

We assessed the rapid on-line evaluation (ROLE) protocol as a modification to the conventional rapid on-site evaluation (ROSE) in the diagnostic performance improvement in endoscopic ultrasound-guided tissue acquisition (EUS-TA) for solid pancreatic lesions. This single-center, retrospective study involved consecutive patients with solid pancreatic lesions undergoing EUS-TA at Peking University First Hospital between October 2017 and March 2021. Among 137 patients enrolled, 75 were in the ROLE group and 62 were in the non-ROSE group. The diagnostic yield (97.3% vs. 85.5%, p = 0.023), accuracy (94.7% vs. 82.3%, p = 0.027), and sensitivity (95.7% vs. 81.1%, p = 0.011) were significantly higher in the ROLE group compared to the non-ROSE group. However, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) showed no significant differences (all p-values > 0.05). Additionally, there was a noteworthy reduction in the number of needle passes required in the ROLE group compared to the non-ROSE group (two vs. three, p < 0.001). In a subgroup analysis, fine needle biopsy (FNB) combined with ROLE demonstrated superior diagnostic accuracy compared to FNB with non-ROSE (100% vs. 93.1%, p = 0.025). Compared with the non-ROSE protocol, the ROLE protocol might improve the diagnostic performance of EUS-TA for solid pancreatic lesions, and potentially reduce the number of needle passes requirement.

Multifunctional Multigate One-Transistor with Thin Advanced Materials, Logic-in-Memory, and Artificial Synaptic Behaviors.

The high device density and fabrication complexity have hampered the development of the electronics. The advanced designs, which could implement the functions of the circuits with higher device density but less fabrication complexity, are hence required. Meanwhile, the MoS2-based devices have recently attracted considerable attention owing to their advantages such as the ultrathin thickness. However, the MoS2-based multifunctional multigate one-transistor (MGT) designs with logic-in-memory and artificial synaptic functions have rarely been reported. Here, an MGT structure based on the MoS2 channel is proposed, with both the logic-in-memory and artificial synaptic behaviors and with more controllable processes than the manual transfer. The proposed MoS2-based MGT functions could be attributed to the semijunction mechanism and enhanced effect of the additional terminals with improved controllability. This study is the first to demonstrate that the neuromorphic computing, logic gate, and memory functions can all be achieved in a MoS2 MGT device without using any additional layers or plasticity to a transistor. The reported results provide a new strategy for developing brain-like systems and next-generation electronics using multifunctional designs and ultrathin materials.

Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study.

OBJECTIVE: This study aimed to report our experience with spinal anesthesia (SA) in patients undergoing L5-S1 interlaminar endoscopic lumbar discectomy (IELD) and clarify its advantages and disadvantages. METHODS: One hundred twelve patients who underwent IELD for an L5-S1 disc herniation under SA were retrospectively analyzed. SA with 0.5% ropivacaine was administered using a 27-gauge fine needle. Intraoperatively, the volume and level of SA, surgical time, blood loss, and cardiopulmonary complications were documented. Postoperative data was collected included the number of patients who ambulated on the day of surgery, incidence of complications and were then statistically analyzed. RESULTS: Analgesia was complete throughout the entire operation in all patients and no other adjuvant intraoperative analgesic drugs were needed. Mean visual analog scale scores for intraoperative and early postoperative (24 h) pain were 0 and 2.43 ± 1.66. SA was administered at the L3-4 interspace in 34 patients (30.4%) and the L2-3 interspace in 78 (69.6%). Administration was successful with the first attempt in all patients. Mean operation time was 70.12 ± 6.52 min. Mean intraoperative blood loss volume was 20.71 ± 5.26 ml. Ninety-eight patients ambulated on the same day as surgery. Mean length of hospital stay was 24.36 ± 3.64 h. Dural injury without damaging the nerve root occurred in one patient. One patient experienced recurrent disc herniation. Intraoperative hypotension and respiratory distress occurred in five (4.5%) and three (2.7%) patients, respectively. Three patients (2.7%) received postoperative analgesia therapy and two (1.8%) experienced nausea. Two patients (1.8%) developed urinary retention. Spinal headache, cauda equina syndrome, and neurotoxicity did not occur. CONCLUSION: SA can achieve satisfactory pain control for patients undergoing IELD with a low incidence of adverse events. SA may be a useful alternative to local and general anesthesia for IELD surgery. Future randomized controlled trials are warranted to investigate.

Clinical outcomes of transforaminal lumbar interbody fusion using a modified posterior spinous process-splitting approach for lumbar degenerative or isthmic spondylolisthesis: a prospective cohort study.

In the conventional posterior approach to the lumbar spine for transforaminal lumbar interbody fusion (TLIF), the paravertebral muscles are stripped from the spinous process. The authors developed a novel surgical procedure in which TLIF was performed via a modified spinous process-splitting (SPS) approach that enabled the preservation of the attachment of the paravertebral muscles to the spinous process. The SPS TLIF group comprised 52 patients with lumbar degenerative or isthmic spondylolisthesis who underwent surgery using a modified SPS TLIF technique, whereas the control group comprised 54 patients who underwent conventional TLIF. Compared with the control group, the SPS TLIF group had a significantly shorter operation time, smaller intra- and postoperative blood loss volumes, and shorter hospital stay and time to ambulation (p < 0.05). The SPS TLIF group had a lower mean visual analog scale score for back pain than the control group on both postoperative day 3 and at 2 years postoperatively (p < 0.05). Follow-up MRI showed changes in the paravertebral muscles in 46 of 54 patients (85%) in the control group and 5 of 52 patients (10%) in the SPS TLIF group (p < 0.001). This novel technique may be a useful alternative to the conventional posterior approach for TLIF.

Clinical Outcomes of Open-Door Laminoplasty Combined with Bilateral Lateral Mass Screw Fixation for Multi-Level Cervical Spinal Stenosis with Traumatic Cervical Instability and Spinal Cord Injury: A Retrospective Study.

OBJECTIVES: The prevalence of multi-level cervical spinal stenosis complicated with traumatic cervical instability and spinal cord injury (MCSS-TCISCI) is low, and the optimal surgical approach remains unclear. Open-door laminoplasty combined with bilateral lateral mass screw fixation (ODL-BLMSF) is a relatively new surgical technique; however, its clinical effectiveness in managing MCSS-TCISCI has not been well-established. This study aims to assess the clinical value of ODL-BLMSF against MCSS-TCISCI. METHODS: We retrospectively analyzed 20 cases of MCSS-TCISCI treated with ODL-BLMSF from July 2016 to June 2020. Radiographic alterations of all included patients were measured using plain radiographs, CT scans, and MRI scans. Cervical lordosis was evaluated using C2-C7 Cobb angle and cervical curvature index (CCI) on lateral radiographs, and Pavlov ratio at the C5 level. Neurological functional recovery was assessed using Japanese Orthopaedic Association (JOA) scores and Nurick grade, while neck and axial symptoms were assessed using the neck disability index (NDI) and the visual analog scale (VAS). The paired t-test was utilized for statistical analysis. RESULTS: All included patients were followed up for an average period of 26.5 months (range: 24-30 months) after ODL-BLMSF. The average Pavlov ratio at the C5 level significantly improved from 0.57 ± 0.1 preoperatively to 1.13 ± 0.1 and 1.12 ± 0.04 at 6 months postoperatively and at the last follow-up (t = 16.347, 16.536, p < 0.001). Importantly, this approach significantly increased the JOA score from 5.0 ± 2.6 before surgery to 11.65 ± 4.3 and 12.1 ± 4.3 at 6 months postoperatively and at the last follow-up (t = 9.6, -9.600, p < 0.001), with an average JOA recovery rate of 59.1%; and the average Nurick disability score decreased from 3.0 ± 1.3 (preoperative) to 1.65 ± 1.22 and 1.5 ± 1.2 (6 months postoperatively and at last follow-up) (t = 5.111, 1.831, p < 0.001). Meanwhile, the NDI score decreased from 30.3 ± 4.3 preoperatively to 13.2 ± 9.2 at 6 months (t = 12.305, p < 0.001), and to 12.45 ± 8.6 at the final follow-up (t = 13.968, p < 0.001), while the VAS score decreased from 4.0 ± 1.5 preoperatively to 1.5 ± 0.7 at 6 months (t = 9.575, p < 0.001), and to 1.15 ± 0.7 at the final follow-up (t = 10.356, p < 0.001). CONCLUSION: ODL-BLMSF can effectively dilate the stenotic spinal canal to decompress the spinal cord, maintain good cervical alignment and stability, and improve the recovery of neurological function and neck function. This technique is suitable for treating selected cases of MCSS-TCISCI.

Effectiveness of Inner Traction-Facilitated Endoscopic Submucosal Dissection Using Rubber Band and Clips for Colorectal Neoplasms: A Propensity Score-Matched Study.

BACKGROUND: Colorectal endoscopic submucosal dissection is a technically demanding but effective treatment for superficial neoplasms. We conducted a study to compare the effectiveness and safety of inner traction-facilitated endoscopic submucosal dissection using rubber band and clip with conventional endoscopic submucosal dissection. METHODS: We retrospectively evaluated 622 consecutive patients who underwent colorectal endoscopic submucosal dissection between January 2016 and December 2019. To overcome selection bias, we used propensity score matching (1:4) between endoscopic submucosal dissection using rubber band and clip and conventional endoscopic submucosal dissection. The frequency of en bloc resections, R0 resections, curative resections, procedure speed, and complications were evaluated. RESULTS: After propensity score matching, 35 patients were included in the endoscopic submucosal dissection using rubber band and clip group and 140 were included in the conventional endoscopic submucosal dissection group. Endoscopic submucosal dissection using rubber band and clip resulted in a significant increase in resection speed (0.14 vs. 0.09 cm2/min; P = .003). There were no significant differences in en bloc, R0, and curative resection rates between the 2 groups. In subgroup analysis, the resection speed of endoscopic submucosal dissection using rubber band and clip was significantly higher than that of conventional endoscopic submucosal dissection when the lesions were equal to or larger than 2 cm, macroscopically presenting as lateral spreading tumor, and located in transverse colon to ascending colon. CONCLUSIONS: Endoscopic submucosal dissection using rubber band and clip is safe and effective in treating colorectal neoplasms, especially in lesions presenting a particular difficulty.

Multiple objective immune wolf colony algorithm for solving time-cost-quality trade-off problem.

The importance of the time-cost-quality trade-off problem in construction projects has been widely recognized. Its goal is to minimize time and cost and maximize quality. In this paper, the bonus-penalty mechanism is introduced to improve the traditional time-cost model, and considering the nonlinear relationship between quality and time, a nonlinear time-cost quality model is established. Meanwhile, in order to better solve the time-cost-quality trade-off problem, a multi-objective immune wolf colony optimization algorithm has been proposed. The hybrid method combines the fast convergence of the wolf colony algorithm and the excellent diversity of the immune algorithm to improve the accuracy of the wolf colony search process. Finally, a railway construction project is taken as an example to prove the effectiveness of the method.

Artificial Intelligence-Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial.

BACKGROUND AND AIMS: Artificial intelligence (AI)-assisted colonoscopy improves polyp detection and characterization in colonoscopy. However, data from large-scale multicenter randomized controlled trials (RCT) in an asymptomatic population are lacking. METHODS: This multicenter RCT aimed to compare AI-assisted colonoscopy with conventional colonoscopy for adenoma detection in an asymptomatic population. Asymptomatic subjects 45-75 years of age undergoing colorectal cancer screening by direct colonoscopy or fecal immunochemical test were recruited in 6 referral centers in Hong Kong, Jilin, Inner Mongolia, Xiamen, and Beijing. In the AI-assisted colonoscopy, an AI polyp detection system (Eagle-Eye) with real-time notification on the same monitor of the endoscopy system was used. The primary outcome was overall adenoma detection rate (ADR). Secondary outcomes were mean number of adenomas per colonoscopy, ADR according to endoscopist's experience, and colonoscopy withdrawal time. This study received Institutional Review Board approval (CRE-2019.393). RESULTS: From November 2019 to August 2021, 3059 subjects were randomized to AI-assisted colonoscopy (n = 1519) and conventional colonoscopy (n = 1540). Baseline characteristics and bowel preparation quality between the 2 groups were similar. The overall ADR (39.9% vs 32.4%; P < .001), advanced ADR (6.6% vs 4.9%; P = .041), ADR of expert (42.3% vs 32.8%; P < .001) and nonexpert endoscopists (37.5% vs 32.1%; P = .023), and adenomas per colonoscopy (0.59 ± 0.97 vs 0.45 ± 0.81; P < .001) were all significantly higher in the AI-assisted colonoscopy. The median withdrawal time (8.3 minutes vs 7.8 minutes; P = .004) was slightly longer in the AI-assisted colonoscopy group. CONCLUSIONS: In this multicenter RCT in asymptomatic patients, AI-assisted colonoscopy improved overall ADR, advanced ADR, and ADR of both expert and nonexpert attending endoscopists. (ClinicalTrials.gov, Number: NCT04422548).

Unilateral transforaminal lumbar interbody fusion through a modified hemilateral spinous process-splitting approach.

Objective: To describe unilateral transforaminal lumbar interbody fusion (TLIF) via a modified hemilateral spinous process-splitting (MHSPS) approach and determine its effectiveness. Methods: Sixty-five consecutive patients with the lumbar degenerative disease who underwent MHSPS TLIF between August 2020 and July 2021 were retrospectively analyzed. Japanese Orthopedic Association (JOA) score and visual analog scale (VAS) scores for back and leg pain were evaluated before surgery and at the last follow-up. Postoperative paraspinal muscle atrophy was evaluated on axial T2-weighted magnetic resonance imaging. Results: Mean JOA score increased from 13.6 ± 3.21 before surgery to 24.72 ± 3.34 at last follow-up (p < 0.001). The mean recovery rate was 68.2% ± 5.68%. Clinical outcome was excellent in 22, good in 35, and fair in 8 patients. The VAS score for low back pain was significantly lower at the last follow-up than before surgery (1.18 ± 0.99 vs. 3.09 ± 1.35; p < 0.001). The VAS score for leg pain was also significantly lower at the last follow-up than before surgery (1.13 ± 0.91 vs. 6.61 ± 1.23; p < 0.001). The mean paraspinal muscle atrophy rate did not significantly differ between the symptomatic side (6% ± 3.8%) and asymptomatic side (4.8% ± 3.3%) at last follow -up (p = 0.071). Conclusion: MHSPS TLIF is an effective minimally invasive surgical treatment for selected types of degenerative lumbar disease. This technique can achieve effective spinal decompression and interbody fusion. Its advantages include direct and adequate visualization, vast surgical working space, short operation time, and minimal muscle injury.

Phenformin suppresses angiogenesis through the regulation of exosomal microRNA-1246 and microRNA-205 levels derived from oral squamous cell carcinoma cells.

Exosomes secreted by cancer cells are important components in the tumor microenvironment, enabling cancer cells to communicate with each other and with noncancerous cells to play important roles in tumor progression and metastasis. Phenformin, a biguanide antidiabetic drug, has been reported to have a strong antitumor function in multiple types of cancer cells, however little research has been reported about whether phenformin can regulate the secretion of exosomes by cancer cells to regulate the tumor microenvironment and contribute to its antitumor function. Here we found that exosomes (Phen-Exo) derived from phenformin-treated oral squamous cell carcinoma (OSCC) cells significantly suppress the proliferation, migration and tube formation of human umbilical vein endothelial cells (HUVECs) in vitro. The inhibition of angiogenesis by Phen-Exo was verified in vivo by matrigel plug angiogenesis assays and by chick chorioallantoic membrane assays. Mechanistically, we discovered that the expression of microRNA-1246 (miR-1246) and microRNA-205 (miR-205) was significantly increased in exosomes secreted by OSCC cells treated with phenformin, while high expression levels of miR-1246 or miR-205 in vascular endothelial cells inhibited their angiogenic effects and decreased expression of the angiogenic factor VEGFA. In conclusion, these results reveal that phenformin can inhibit angiogenesis by regulating the levels of miR-1246 and miR-205 in exosomes secreted by OSCC cells, suggesting that phenformin has the potential to alter the tumor microenvironment to antagonize the growth of OSCCs, which provides a theoretical basis for developing new strategies to treat OSCCs in the future.

Phenformin Down-Regulates c-Myc Expression to Suppress the Expression of Pro-Inflammatory Cytokines in Keratinocytes.

The treatment of many skin inflammation diseases, such as psoriasis and atopic dermatitis, is still a challenge and inflammation plays important roles in multiple stages of skin tumor development, including initiation, promotion and metastasis. Phenformin, a biguanide drug, has been shown to play a more efficient anti-tumor function than another well-known biguanide drug, metformin, which has been reported to control the expression of pro-inflammatory cytokines; however, little is known about the effects of phenformin on skin inflammation. This study used a mouse acute inflammation model, ex vivo skin organ cultures and in vitro human primary keratinocyte cultures to demonstrate that phenformin can suppress acute skin inflammatory responses induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in vivo and significantly suppresses the pro-inflammatory cytokines IL-1ß, IL-6 and IL-8 in human primary keratinocytes in vitro. The suppression of pro-inflammatory cytokine expression by phenformin was not directly through regulation of the MAPK or NF-κB pathways, but by controlling the expression of c-Myc in human keratinocytes. We demonstrated that the overexpression of c-Myc can induce pro-inflammatory cytokine expression and counteract the suppressive effect of phenformin on cytokine expression in keratinocytes. In contrast, the down-regulation of c-Myc produces effects similar to phenformin, both in cytokine expression by keratinocytes in vitro and in skin inflammation in vivo. Finally, we showed that phenformin, as an AMPK activator, down-regulates the expression of c-Myc through regulation of the AMPK/mTOR pathways. In summary, phenformin inhibits the expression of pro-inflammatory cytokines in keratinocytes through the down-regulation of c-Myc expression to play an anti-inflammation function in the skin.

[Imaging measurement for the posterior pars interarticularis screw fixation on axis].

OBJECTIVE: To explore the safety and feasibility of posterior pars interarticularis screw fixation on axis by CT measurement. METHODS: The CT data of 137 patients with complete upper cervical spine who underwent full cervical spine CT examination from January 2016 to December 2019 were collected, including 71 males and 66 females, aged from 22 to 65 years old with an average of (41.8±17.4) years old. Mimics 19.0 software was used to measure anatomical data related to the pars interarticularis screw, including the pars width, pars vertical length, pars vertical height, length of pars screw trajectory, upward inclination angle of pars screw trajectory. And the correlation between each index was analyzed. RESULTS: The axis pars has an average width of (9.05±1.63) mm, an average vertical length of (11.21±1.43) mm, and an average vertical height of (17.53±2.93) mm. The mean length of pars screw trajectory was(19.07±3.20) mm. Regarding to the length of pars screw trajectory, 94.53% of pars measured more than 14 mm, 82.12% of pars measured at 14-16 mm, 63.14% of pars measured at 16-18 mm, 39.78% of pars measured at 18-20 mm. The upward inclination angle of pars screw was 30°-68° with an average of (46.06±8.06) °. There was a highly positive correlation between the length of screw trajectory and upward inclination angle(r=0.965, P=0.000). The vertical length of pars was weakly positively correlated with length of screw trajectory and upward inclination angle(r=0.240, P=0.000;r=0.163, P=0.007). Pars width was moderately negative correlated with length of scrwe trajectory and upward inclination angle(r =-0.333, P=0.000;r=-0.380, P=0.000). CONCLUSION: The posterior pars interarticularis screw fixation is safe and reliable. It has a more wider applicability than pedicle screw fixation and can be used as an alternative to pedicle screws.