Initial Experience and Analysis of Outcomes Using the Visualized Percutaneous Endoscopic Lumbar Discectomy Technique for the Treatment of Lumbar Disc Herniation.

AIM: To introduce a visual surgical concept using a retrospective comparison of the outcomes between visualized percutaneous endoscopic lumbar discectomy (V-PELD) and conventional PELD techniques. MATERIAL AND METHODS: Data from 61 patients in the conventional PELD group and 55 in the V-PELD group. Data included the duration of the operation, number of intraoperative radiation exposure events, and follow-up information for 24 months. The Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were collected. RESULTS: The mean (± SD) operating time for the V-PELD group was 57.82 ± 11.25 min, and the mean duration of radiation exposure was 0.74 ± 0.32 min. The mean operating time for the conventional group was 63.16 ± 14.49 min (p < 0.05), and the mean duration of radiation exposure was 2.81 ± 1.12 min (p < 0.001). All patients in both groups demonstrated significant improvement in the ODI and VAS scores after surgery (p < 0.05). CONCLUSION: V-PELD is a minimally invasive surgical technique that involves less radiation exposure and is more efficient for treating lumbar disc herniation.

Percutaneous endoscopic lumbar discectomy and microsurgical laminotomy : A prospective, randomized controlled trial of patients with lumbar disc herniation and lateral recess stenosis.

BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control. MATERIAL AND METHODS: We examined patients who had LDH with lateral recess stenosis and compared the results of nerve root canal decompression using percutaneous endoscopic lumbar discectomy (PELD) with a microsurgical laminotomy (ML) technique. In this study 40 patients with full endoscopic decompression or microsurgery were followed up for 2 years. In addition to general and specific parameters, the following two parameters were also used for the investigation: the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Except for 1 patient in whom repair was done by fusion and 1 who was lost to follow-up, 38 patients remained in the study over the 2 years. The mean operating time in the PELD group was longer (p < 0.05), but intraoperative and postoperative blood loss was less than in the ML group (p < 0.05). The postoperative results were better than before surgery, and the VAS and ODI parameters indicated a clear improvement in leg pain and daily activities in both groups (p > 0.05). Of the patients three suffered increasing back pain (2 ML, 1 PELD). CONCLUSION: The results indicated that the PELD can provide an effective supplement and serve as an alternative for LDH with lateral recess stenosis compared with the ML technique when the indication criteria are fulfilled. The PELD also has the advantage of being a minimally invasive intervention.

All-trans-retinoic acid promotes iodine uptake via up- regulating the sodium iodide symporter in medullary thyroid cancer stem cells.

Recently, the main therapy of medullary thyroid cancer (MTC) is surgical, but by which way there is a poor prognosis with a mean survival of only 5 years. In some cases, some researchers found that it is the medullary thyroid cancer stem cells (MTCSCs) that cause metastasis and recurrence. This study aimed to eradicate MTCSCs through administration of all-trans-retinoic acid (ATRA). Here we demonstrate that MTCSCs possess stem- like properties in serum-free medium. The ABCG2, OCT4 and sodium iodide symporter (NIS) were changed by ATRA. Additionally, we found that ATRA can increase the expression of NIS in vivo. All the data suggested that ATRA could increase the iodine uptake of MTCSCs through NIS.