[Jiawei shentong zhuyu decoction prevented the occurrence of failed back surgery syndrome and its effect on serum TNF-alpha a clinical study].

OBJECTIVE: To explore the clinical roles of Jiawei Shentong Zhuyu Decoction (JSZD) in preventing the occurrence of failed back surgery syndrome (FBSS), and to observe its effect on serum tumor necrosis factor-alpha (TNF-alpha). METHODS: Totally 100 patients prepared for surgical operation due to lumbar intervertebral disc herniation were randomly assigned to the treatment group and the control group according to random number table, 50 cases in each group. Patients in the treatment group additionally took JSZD, one dose per day, taken in two portions, once in the morning and once in the evening. Those in the control group took Celecoxib Capsule (200 mg each time, once per day) and Mecobalamin Tablet (0.5 mg each time, 3 times per day). They only took Mecobalamin Tablet from the 11th day. All patients were treated for 30 days. Japanese Orthopaedic Association (JOA) score was performed before treatment, at week 1, after treatment, at 6 months of followed-ups, and at 12 months of followed-ups. And the levels of TNF-alpha in the peripheral blood were observed before treatment and at one month after treatment. RESULTS: Totally 93 patients completed the followed-up study. The JOA scores were improved after treatment, at 6 and 12 months of followed-ups (P < 0.05, P < 0.01). The JOA score at 6 months of followed-ups was superior in the treatment group to that of the control group (P < 0.05). Five patients (accounting for 10.6%) suffered from FBSS in the treatment group, while 9 (accounting for 19.6%) suffered from FBSS in the control group. The treatment group was superior to the control group (P < 0.05). The TNFalpha level was improved after treatment in the two groups. Of them, the improvement of TNF-alpha in the treatment group was better than that of the control group (P < 0.05). CONCLUSION: The application of JSZD was effective for preventing the occurrence of FBSS, and improved the serum TNF-alpha level.

[Treating cervical spinal canal stenosis by open-door cervical laminoplasty combined modified buyang huanwu decoction].

OBJECTIVE: To explore the clinical efficacy of open-door cervical laminoplasty combined Modified Buyang Huanwu Decoction (MBHD) to treat cervical spinal canal stenosis (CSCS). METHODS: Totally 32 CSCS patients were randomly assigned to two groups, Group A (17 cases, treated by laminoplasty) and Group B (15 cases, treated by laminoplasty combined MBHD). All patients received open-door cervical laminoplasty. Those in Group B took MBHD additionally for 2 weeks after surgery. The visual analogue scale (VAS), the Japanese Orthopedic Association (JOA) score, and the neck disability index (NDI) were measured preoperative, postoperative 3 months and 12 months, respectively. RESULTS: There was no statistical difference in preoperative VAS, JOA, or NDI (P > 0.05). The VAS, JOA, and NDI were obviously improved 3 months and 12 months after surgery in the two groups, showing statistical difference when compared with before surgery in the same group (P < 0.01). At 3 months after surgery the aforesaid indices in Group B were superior to those in Group A (P < 0.05). There was no statistical difference in the aforesaid indices between the two groups at 12 months after surgery (P > 0.05). CONCLUSION: MBHD favorably improved early recovery of neural functions of CSCS patients (3 months after surgery).

Efficacy and safety of magnetic resonance-guided focused ultrasound for the treatment of osteoid osteoma: A systematic review and meta-analysis.

OBJECTIVE: Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate the efficacy and safety of MRgFUS in the treatment of OO through a systematic review and meta-analysis of pain scores and post-treatment adverse events before and after MRgFUS treatment. MATERIALS AND METHODS: A comprehensive literature search of PubMed, Embase, Web of science, and Cochrane Library databases was conducted to screen the study literature based on inclusion and exclusion criteria to extract and analyze pre- and post-treatment pain score data, success rates (complete pain relief with no recurrence until the last follow-up), recurrence rates, secondary intervention rates, and complications to evaluate the efficacy and/or safety of MRgFUS for OO. RESULTS: A total of 113 studies published between 2012 and 2022were collected, resulting in a total sample size of 353 patients. The majority of the studies were prospective and had a follow-up period of 4 weeks or more, and overall, the quality of evidence ranged from low to high. Pain scores at 1 week and 1 month after the merger were 0.62 (9.5% CI:0.28-0.96) and 0.37 (9.5% CI:0.07-0.68), respectively. The success rate of the combination was 92.8% (95% CI: 89.8%-95.7%), the incidence of minor complications (thermal injury at the ablation site) was 0.85%, and no major complications were recorded in any of the included literature. CONCLUSION: MRgFUS is an effective procedure that is able to treat pain for patients with OO with satisfying efficacy and safety. PROSPERO: No.CRD42023415573.

Construction of a virtual reality platform for computer-aided navigation Lingnan bone setting technique.

To establish a standard Traditional Chinese medicine (TCM) bone setting technique, standardize the operation and inherit the TCM bone setting technique. This project was based on the interactive tracking of bone setting techniques with a dedicated position tracker, the motion tracking of bone setting techniques based on RGBD (Red Green Blue Depth) cameras, the digital analysis of bone setting techniques, and the design of the virtual reality platform for bone setting techniques. These key technical researches were combined to construct an interactive bone setting technique. The virtual simulation system can reproduce the implementation process of the expert's bone setting technique. The user can observe the implementation of the manipulative technique from multiple angles; through human-computer interaction, the whole process of implementation of the bone setting technique can be simulated, and the movement and reduction of the affected bone can be observed at the same time. It can be used as a teaching and training system for assisting bone setting techniques. Students can use the system to carry out repeated self-training, and can instantly compare with the standard techniques of the expert database, breaking the traditional teaching mode of 'expected and unspeakable' and avoid directly using patients. Therefore, this research makes it possible to reduce teaching costs, reduce risks, improve teaching quality, and make up for the lack of teaching conditions. It is very positive for the inheritance of the traditional Chinese 'intangible culture' of bone setting techniques, and to promote the digitalization and standardization of bone setting techniques.

Using computer technology to digitally record bone-setting manipulations.Construct a virtual simulation system for interactive bone-setting manipulation.Promote the digitization and standardization of bone-setting techniques.

Outcomes of autograft alone versus PEEK+ autograft interbody fusion in the treatment of adult lumbar isthmic spondylolisthesis.

OBJECTIVES: Bone resulting from a complete resection of the posterior arch can be cut into an autograft bone that contains the facet joint structure and morselised bone for interbody fusion. However, whether a strut autograft that contains this trimmed facet joint can produce the same clinical and radiographic outcomes as a cage for interbody fusion remains unclear. The aim of this study was to compare the outcomes of a local facet joint autograft alone to those of polyetheretherketone (PEEK)+autograft for posterior lumbar interbody fusion (PLIF) in the treatment of adult isthmic spondylolisthesis. PATIENTS AND METHODS: A retrospective analysis was performed on 84 patients with single lumbar isthmic spondylolisthesis who were treated with a local facet joint autograft alone (group A; n=44) or PEEK+autograft (group B; n=40) in PLIF with a minimum follow-up period of 24 months. Pain and disability were assessed using the visual analogue scale, Oswestry disability index and Kirkaldy-Willis criteria. In the radiological evaluation, disc height, slippage reduction, and fusion status were examined. Postoperative complications were also monitored. RESULTS: At the last follow-up examination, 84.1% (37/44) of the patients in group A and 82.5% (33/40) of the patients in group B had a good outcome, and there were no significant differences between the two groups. Boh Methods led to significant improvements in disc height, and while PEEK+autograft produced a smaller loss in disc height, the difference was insignificant. The improvements in slippage and the fusion and complication rates between the two groups were similar. CONCLUSION: There were no significant differences in the clinical outcomes or radiographic improvements of both fusion methods in the treatment of adult isthmic spondylolisthesis. An autograft excised from a complete posterior arch containing a facet joint for interbody fusion is effective and affordable for treating isthmic spondylolisthesis.

[Comparison of inter- and intra-observer reliability between GATA and SMU classification systems for spinal tuberculosis].

OBJECTIVE: To compare the inter- and intra-observer reliability of the GATA and SMU classification systems for spinal tuberculosis and assess the clinical value of SMU classification. METHODS: One hundred patients with spinal tuberculosis treated in our hospital from January 2004 to December 2011 were randomly selected for analysis, including 54 males and 46 females with a mean age of 45 years (range, 16-68 years). All the patients had X-ray, CT and MRI examinations. Five observers experienced in spinal tuberculosis independently assigned the classification using the GATA and SMU classification systems, and the assignment was repeated 3 months later to test its reproducibility. Kappa value was used to determine the intra- and inter-observer reliability. RESULTS: For GATA and SMU classification systems, the inter-observer percentage of agreement averaged (59.9∓4.84)% (κ=0.412∓0.058) and (81.6∓6.06)% (κ=0.753∓0.068), and the intra-observer percentage of agreement was (75.6∓5.27)% (κ=0.624∓0.078) and (89.8∓2.28)% (κ=0.862∓0.037), respectively. CONCLUSION: The SMU classification system of spinal tuberculosis has a higher inter-observer and intra-observer reliability than the GATA classification system, but its clinical value needs to be further tested in future clinical trials.

[Minimally invasive surgical treatment for lumbar degenerative disease with IsoC-3D navigation under Mast Quadrant system].

OBJECTIVE: To evaluate the effects of surgical treatment of IsoC-3D navigation assisted percutaneous pedicle screw fixation,vertebral canal decompression and interbody fusion using Mast Quadrant system in patients with lumbar degenerative disease. METHODS: From January 2009 to February 2010,21 patients with lumbar degenerative disease were treated with IsoC-3D navigation under Mast Quadrant system. There were 12 males and 9 females, with an average age of 50.2 years (ranged,36 to 72 years). All patients underwent discectomy,vertebral canal decompression, cage implantation using Mast Quadrant system and IsoC-3D navigation assisted sextant lumbar fixation. Clinical outcomes were evaluated with Oswestry disability index (ODI), Visual analog scale (VAS) and degree of satisfaction of patients. RESULTS: Eighteen patients (85.7%) were followed up from 6 to 18 months with an average of 10 months. No surgery-related complications were found. The preoperative, postoperative ODI scores was 49.6 +/- 12.2 and 17.2 +/- 9.2, respectively (P < 0.01); VAS score of leg pain decreased from preoperative 75.2 +/- 10.0 to 12.2 +/- 11.8 at final follow-up (P < 0.01); VAS score of lumbago decreased from preoperative 59.9 +/- 17.3 to 16.6 +/- 11.5 at final follow-up (P < 0.01). Sixteen patients obtained satisfactory results. CONCLUSION: IsoC-3D navigation assisted percutaneous pedicle screw fixation,vertebral canal decompression and interbody fusion using Mast Quadrant system could achieve satisfactory clinical results in treating lumbar degenerative disease and may be a better alternative to conventional surgical procedures. It has advantages such as limited tissue damage, less blood loss, short time in hospital.