[Preliminary clinical study on the posterior lumbar minimally invasive surgery assisted by 3D-Viewer system under a direct vision].

OBJECTIVE: To study the methods and preliminary clinical efficacy of posterior lumbar minimally invasive surgery assisted by 3D-Viewer system under a direct vision and provide rationales for further clinical applications. METHODS: From September 2008 to September 2009, a total of 84 lumbar degenerative disease patients were enrolled and randomly divided into 2 groups (n = 42 each). One group was treated operatively by 3D-Viewer system under a direct vision while another treated with conventional operations. The lumbar paraspinal muscle approach was employed. Surgery was assisted by 3D-Viewer system under a direct vision. The operative duration, intra-operative blood loss volume, CK (creatine kinase) levels at Days 1 & 7 post-operation, atrophic rates of cross-sectional areas of bilateral multifidus muscles on MRI (magnetic resonance imaging) at 12 months post-operation were recorded. At Month 12 post-operation, the therapeutic efficacy was evaluated by Oswestry disability index (ODI) and the post-operative clinical effects assessed. RESULTS: The operative duration, intra-operative blood loss volume and CK level at Days 1 & 7 post-operation were statistically different (P < 0.05); there was significant difference in the atrophic rates of cross-sectional areas of bilateral multifidus muscles on MRI and the improvement rates of ODI (P < 0.001); the therapeutic efficacy of the invasive group was significantly better than that of the group treated with traditional operations (P < 0.05). CONCLUSION: The 3D-Viewer technique reduces the risk of damage. As an ideal minimally invasive procedure, it may achieve satisfactory outcomes for spinal diseases.

[The correlation between the level of serum VEGF and bFGF with metastasis and prognosis of osteosarcoma].

AIM: To investigate the correlation between the level of serum VEGF and bFGF with metastasis and re- currence of osteosarcoma. METHODS: 52 patients with osteosarcoma and 60 healthy people as control group were selected. The serum contents of VEGF and bFGF were determined with ELISA before and after operation. RESULTS: The serum contents of VEGF and bFGF before operation were significantly higher than that in control group ( P < 0.01). The serum contents of VEGF and bFGF after operation descreased significantly but were significantly higher than that in control group(P<0. 01). The serum contents of VEGF and bFGF before operation were positively related to the size of primarily tumor, Enneking type and tumor differentiation(P<0.05). The serum contents of VEGF and bFGF before and after operation were different significantly between recurrence and metastasis positive group with recurrence and metastasis negative group ( P < 0. 01). The Cox proportional hazards model showed that the serum contents of VEGF and bFGF before and after operation were an independent factor of the recurrence and metastasis for osteosar- coma patients after operative ( P <0. 01). CONCLUSION: The serum contents of VEGF and bFGF before and after operation can offer valuable assessments in evaluation of progression and metastasis prognosis.

[Metrx quadrant system in the surgery of lumbar spondylolisthesis: preliminary clinical application].

OBJECTIVE: To evaluate the clinical efficacy and minimal invasiveness of quadrant posterior distraction system in the posterior lumbar spondylolisthesis (LS) surgery. METHODS: Sixty-one LS patients were randomly divided into two groups: quadrant posterior minimally invasive surgery system as invasive group (n = 30) and traditional open surgery as open group (n = 31). The clinical outcome of pain relief was assessed by the scoring systems of visual analogue scale (VAS) and Oswestry disability index (ODI) for low back pain. Radiographic assessment: preoperative and 1-day, 3-month and last follow-up (12 months) radiographs were analyzed including the index of relative posterior disc height. RESULTS: The scores of VAS and ODI of invasive group were less than open group at Months 3 and 12 post-operation (P < 0.01). Relative posterior disc height of intra-operation and Month 3 was not significantly different (P > 0.05). And there was only statistical significance difference within 12 months (P < 0.05). At Month 12 post-operation, the fluctuating rate was slight. CONCLUSION: The minimally invasive operation with Quadrant is less traumatic to the patients than traditional open operation in the protection of spinal stability, postoperative rehabilitation and radiographs. This new minimally invasive spine technique should be popularized.