3D-printed guides versus computer navigation for pedicle screw placement in the surgical treatment of congenital scoliosis deformities.

BACKGROUND: To compare the safety and clinical outcomes of 3D-printed guides versus computer navigation for pedicle screw placement in the correction of congenital scoliosis deformities. METHODS: The study was a single-centre retrospective controlled study and was approved by the hospital ethics committee for the analysis all patients under the age of 18 years with at least 2 years of follow-up. Sixty-three patients who underwent surgical correction for congenital scoliosis deformities in our hospital from January 2015 to December 2020 were divided into two groups based on the decision following preoperative doctor‒patient communication. Among them, 43 patients had pedicle screws placed with 3D-printed guider plates, while the remaining 20 patients had screws inserted with the assistance of computer navigation. The perioperative period, follow-up results and imaging data were compared between the groups. RESULTS: The operation was completed successfully for patients in both groups. The 3D-printed guide-assisted screw placement technique proved to be significantly superior to the computer navigation technique in terms of operation time, screw placement time, and intraoperative blood loss (p < .05), although the former had more frequent intraoperative fluoroscopies than the latter (p < .05). The mean follow-up time was 41.4 months, and the SRS-22 scores significantly improved in both groups over time postoperatively (p < .05). The 3D-printing group had better SRS-22 scores than the navigation group 6 months after surgery and at the last follow-up (p < .05). Compared with preoperative values, the coronal Cobb angle, local kyphotic Cobb angle, C7-S1 coronal deviation (C7PL-CSVL), and sagittal deviation (SVA) were significantly improved in both groups after surgery (p < .05). CONCLUSION: Both techniques achieve the purpose of precise screw placement and proper correction of the deformities. In contrast, the 3D-printed guide-assisted screw placement technique showed advantages in terms of operation time, screw placement time, intraoperative blood loss and patient satisfaction with outcomes.

Human neural stem cells.

'Human neural stem cells' jointly drafted and agreed upon by experts from the Chinese Society for Stem Cell Research, is the first guideline for human neural stem cells (hNSCs) in China. This standard specifies the technical requirements, test methods, test regulations, instructions for use, labelling requirements, packaging requirements, storage requirements, transportation requirements and waste disposal requirements for hNSCs, which is applicable to the quality control for hNSCs. It was originally released by the China Society for Cell Biology on 30 August 2022. We hope that publication of the guideline will facilitate institutional establishment, acceptance and execution of proper protocols, and accelerate the international standardization of hNSCs for clinical development and therapeutic applications.

Therapeutic effect of minimally invasive catheter drainage and local chemotherapy for the lumbosacral tuberculosis without neural symptoms.

Increasing number of studies have shown growing incidence of lumbosacral tuberculosis and its complications. However, the treatment options for this disorder are still limited.To evaluate the long-term therapeutic effect and prognosis of minimally invasive puncture catheter drainage and Isoniazid local chemotherapy for the treatment of lumbosacral tuberculosis without neural symptoms under the guidance of computed tomography (CT).A total of 45 patients with asymptomatic lumbosacral tuberculosis were treated by minimally invasive catheter drainage under CT guidance. Forty-two cases had been followed up, which included 22 women and 20 men with an average age of 36.45 years old. Isoniazid was injected locally and antituberculotic drugs were administered for postoperative treatment. Oswestry Disability Index (ODI), visual analogue scale (VAS) evaluation and Cobb angle were recorded before and after operation.Forty-two patients had been followed up and the follow-up term was from 1.2 to 8.5 years (average 60 months). All patients were healed without recurrent cases. The ODI were improved from 14.86 ±â€Š2.02 before operation to 1.48 ±â€Š1.55 after operation. The post-operative (4.19 ±â€Š1.17) VAS score was improved compared to the pre-operative VAS score (0.55 ±â€Š0.55). The post-operative Cobb angle (6.19°â€Š±â€Š3.85°) was also improved relatively to the preoperative Cobb angle (5.90°â€Š±â€Š3.71°).Minimally invasive puncture catheter drainage combined with Isoniazid local chemotherapy is an effective method for lumbosacral tuberculosis without neural symptom. Meanwhile, it can be applied for the treatment of spinal tuberculosis before open surgery.

A new method for calculating the desired laminoplasty opening size based on the target sagittal canal diameter before single-door cervical laminoplasty.

PURPOSE: To build a mathematical model which could calculate the desired laminoplasty opening size (LOS) based on the target sagittal canal diameter (SCD) before single-door cervical laminoplasty (SDCL) when taking the effects of surgery drill into consideration. METHODS: The model was based on geometric analysis on deformation of spinal canal; the formula was derived and characterized as: y (mm) = 2 [Formula: see text] × sin(ß/2) = c - d (y is the size of LOS, [Formula: see text] the size of transverse canal diameter, ß the size of laminoplasty opening size, c the size of mini-plate and d the diameter of the drill bit used during the surgery operation). The parameters of pre- and postoperative computed tomography scans of 20 patients who had undergone SDCL were measured by the picture archiving and communication system (PACS) software and a new instrument named as Lei's ruler, respectively. RESULTS: The effects of surgery SDCL were very significant; for each patient, the SCD was enlarged dramatically after the surgery (P < 0.01). The differences between the data obtained by PACS and Lei's ruler were no statistically significant (P > 0.05). According to the derived formula, the 95% confidence intervals of SCD after the surgery were within the range of 14 mm and 14.5 mm. CONCLUSION: Applying the mathematical model and derived formula, the desired LOS could be calculated according to the target SCD which could help the surgeon select an optimum mini-plate before SDCL. At the same time, a new measuring device named Lei's ruler is designed for the convenience of the derived formula. These slides can be retrieved under Electronic Supplementary Material.

Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up: An observational study.

The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.

Polymorphisms in the estrogen receptor genes are associated with hip fractures in Chinese.

INTRODUCTION: Hip fractures (HF) are a major cause of public health burden with strong genetic determination. However, the true causal genes remain largely unknown. MATERIALS AND METHODS: Based on the important biological role of estrogens in bone homeostasis, this study aimed to investigate whether the estrogen receptor genes, ESR1 and ESR2, affect the onset of HF in 700 elderly Chinese subjects (350 with osteoporotic HF and 350 healthy controls). We genotyped 32 SNPs in total and examined their associations both by the single-SNP and haplotype tests. RESULTS: We identified two novel SNPs of ESR1, rs3020314 and rs1884051, were significantly associated with HF (rs3020314: P=0.0004, OR=1.66, 95%CI: 1.25-2.18; rs1884051: P=0.0004, OR=1.46, 95%CI: 1.19-1.81). We firstly detected significant association of ESR2 with HF (rs960070: P=0.0070, OR=1.43, 95%CI: 1.10-1.86). Haplotype analyses corroborated our single-SNP results. CONCLUSION: Our findings have important implications for understanding the pathology of osteoporotic fractures. Independent replication studies are needed to validate our results and explore the most possible functional variants for molecular studies.

[Update of combined therapies with docetaxel for hormone-independent prostate cancer].

Hormone-independent prostate cancer (HIPC) is the end stage of prostate cancer, with a short median survival of 9-18 months for the patients. Two large phase III studies have demonstrated a survival advantage of docetaxel chemotherapy in HIPC patients. New combined protocols have been developed with promising results. These protocols propose a combination with docetaxel, chemotherapy, antiangiogenic agents, vaccine and biological drugs. This review focuses the progress achieved the combined therapies for HIPC.