Gradual Traction Reduction With the Ilizarov Method for Tile C1.2 Old Pelvic Fracture: A Case Report.

CASE: A 20-year-old man with a Tile C1.2 pelvic fracture was treated with skeletal traction. After 3 months, the patient was unable to stand and walk, and the right lower limb was shortened by 7 cm. Radiographs showed that the sacroiliac joint dislocation was not reduced. Gradual traction reduction with the Ilizarov method was used to correct sacroiliac joint dislocation, and open internal fixation was performed. Postoperatively, the old pelvic fracture was successfully reduced without sacral plexus injury. CONCLUSION: Gradual traction reduction with the Ilizarov method can reduce the risk of sacral plexus injury and achieve satisfactory reduction of Tile C1.2 old pelvic fractures.

Modified Unilateral Biportal Endoscopic Lumbar Discectomy Results in Improved Clinical Outcomes.

OBJECTIVE: To evaluate and describe the clinical efficacy and safety of a modified unilateral biportal endoscopic lumbar discectomy. METHODS: From February 2019 to February 2020, patients who met the inclusion criteria were treated using a modified unilateral biportal endoscopic lumbar discectomy. During the operation, the herniated disc was removed and the ligamentum flavum was preserved. Clinical efficacy was assessed via postoperative imaging and follow-up. RESULTS: A total of 70 patients were followed up for more than 2 years, including 51 males and 19 females, aged 49.4 ± 16.0 years. All operations were completed and no complications were noted. Postoperative lumbar magnetic resonance imaging showed that the decompression of the nerve root was sufficient and the ligamentum flavum was preserved in all patients. Postoperative lumbar CT showed that the caudal lamina and inferior articular process of the cephalad vertebral were partially removed. Lower back and leg pain were significantly relieved after surgery, and the Oswestry Disability Index was significantly improved compared to presurgery measurements (P ＜ 0.01). After 2 years of follow-up, the sensory and muscle strength of nerve roots were significantly recovered (P ＜ 0.01). According to the MacNab score of the patients, 40 cases were defined as "excellent," 26 cases were "good," 2 cases were "fair," and 2 cases were "poor." CONCLUSIONS: Modified unilateral biportal endoscopic lumbar discectomy can completely remove a lumbar herniated disc; relieve lower back and leg pain; improve lumbar function; reduce the risk of dural tearing, cerebrospinal fluid leakage, and epidural hematoma; and reduce the epidural adhesion and arachnoiditis caused by ligamentum flavum resection.

Full-Endoscopic Lumbar Interbody Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion with a Tubular Retractor System: A Retrospective Controlled Study.

OBJECTIVE: The objective of this study was to compare the safety and clinical efficacy of full-endoscopic lumbar interbody fusion (FE-LIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: A total of 70 patients with single-level lumbar degenerative diseases underwent FE-LIF or MIS-TLIF with a tubular retractor system from August 2018 to August 2020. Postoperatively, the efficacy and safety were compared using several clinical and radiological indices. RESULTS: A total of 32 patients underwent FE-LIF and 38 received MIS-TLIF with a tubular retractor system, and all patients had no apparent complications. The FE-LIF group had higher radiation exposure, longer operation time, and less bleeding than the MIS-TLIF group (P < 0.05). Postoperative lumbar magnetic resonance imaging showed that the nerve decompression was sufficient. The pain in the lower back and legs was significantly relieved, and the Oswestry Disability Index (ODI) score was greatly improved after surgery (P < 0.01) in both the groups. The sensory and motor functions of nerve roots were remarkably recovered in both the groups at the 1-year follow-up (P < 0.05), and there was no significant difference in MacNab scores between the 2 groups. As per Mannion's fusion classification, the interbody fusion rate was significantly better in the FE-LIF group than in the MIS-TLIF group. CONCLUSIONS: FE-LIF, which is safe, effective, and minimally invasive, exhibits the same clinical efficacy as MIS-TLIF but with longer operation time and increased radiation exposure.

Technical Notes of Full Endoscopic Lumbar Interbody Fusion with Anterior Expandable Cylindrical Fusion Cage: Clinical and Radiographic Outcomes at 1-Year Follow-Up.

OBJECTIVE: We sought to introduce technical notes of full endoscopic lumbar interbody fusion (FE-LIF) with an anterior expandable cylindrical fusion cage. METHODS: This study retrospectively reviewed patients who underwent FE-LIF with an anterior expandable cylindrical fusion cage through transforaminal or interlaminar approaches from August 2018 to April 2019. Patient demographics and operation-related complications were recorded. Clinical and radiologic outcomes were evaluated at 1 year after surgery. RESULTS: A total of 32 patients (34 segments) were included in this study. Among them, 14 received full endoscopic transforaminal lumbar interbody fusion and 18 received full endoscopic interlaminar lumbar interbody fusion. There were significant differences in interbody fusion indications between the 2 groups (P < 0.05). All operations were successfully completed without complications. Postoperative lumbar magnetic resonance imaging showed that nerve decompression was sufficient in all patients, and the visual analog scale scores of low back pain and leg pain, the Oswestry Disability Index scores, and sensory and muscle strength were significantly improved after surgery (P < 0.01). The MacNab score included 9 excellent ratings, 4 good ratings, and 1 fair rating in the full endoscopic transforaminal lumbar interbody fusion group and included 10 excellent ratings and 8 good ratings in the full endoscopic interlaminar lumbar interbody fusion group; the scores were not significantly different between the 2 groups at 1 year after surgery (P > 0.05). Complete interbody fusion was achieved in both groups according to computed tomography at 1 year after surgery. CONCLUSIONS: FE-LIF is a safe and effective minimally invasive lumbar surgery with an anterior expandable cylindrical fusion cage.

Full-Endoscopic Oblique Lateral Lumbar Interbody Fusion: A Technical Note With 1-Year Follow-Up.

BACKGROUND: Oblique lateral lumbar interbody fusion (OLLIF) is a minimally invasive lumbar interbody fusion procedure using a bullet-shaped polyetheretherketone (PEEK) nonexpandable fusion cage modified to diminish risk to the exiting nerve root during posterolateral implantation through the Kambin safe zone under fluoroscopic guidance. The objective of this study was to present feasibility of this procedure and 1-year clinical outcome data. METHODS: The authors present a prospective cohort study of 20 patients who underwent fluoroscopy-guided and full-endoscopic OLLIF in 22 segments allowing protection of the exiting nerve root from January 2018 to March 2019. The foraminoplasty, discectomy, endplate preparation, placement of bone graft and insertion of the fusion cage was done under continuous full-endoscopic visualization. The OLLIF fusion was backed up with bilateral percutaneous posterior supplemental pedicle screw fixation. Primary clinical outcome measures were the visual analog scale (VAS) of low back and leg pain, and Oswestry disability index (ODI) at 1 week, 3 months, 6 months, and 1 year after the operation. At final follow-up, the Macnab score was also evaluated. Secondary outcome measures were computed tomography (CT) assessment fusion using the Mannion classification of spinal fusion and adverse events related to the device as well as magnetic resonance imaging (MRI) assessment of nerve root decompression. RESULTS: All patients had significant relief of low back pain and leg pain, by VAS and ODI scores that improved significantly (P < .01). There were no complications. Postoperative lumbar MRI of all patients showed sufficient direct nerve decompression. At 1-year follow-up, excellent Macnab outcomes were obtained 13 patients, good in six, and fair in one. Impaired sensation and muscle strength of the involved nerve root significantly recovered in all but 2 patients (P < .05). According to the Mannion CT-based classification of spinal fusion, CT showed complete interbody fusion achieved in all 22 segments. CONCLUSIONS: Full-endoscopic OLLIF is a safe, effective, minimally invasive, economical, practical, and widely applicable minimally invasive interbody fusion technique in the lumbar spine. LEVEL OF EVIDENCE: 3.

Relationship between granulomatous lobular mastitis and methylene tetrahydrofolate reductase gene polymorphism.

BACKGROUND: Variations in the methylene tetrahydrofolate reductase (MTHFR) gene have been reported as risk factors for numerous conditions, including cardiovascular disease, thrombophilia, stroke, hypertension and pregnancy-related complications. Moreover, it was reported there is an association between breast cancer and mutations in MTHFR-C677T. However, whether there is an association between MTHFR gene polymorphism and granulomatous lobular mastitis or not has been rarely investigated. AIM: To analyze the association between MTHFR gene polymorphism and granulomatous lobular mastitis. METHODS: Fifty-one patients with granulomatous lobular mastitis admitted to The First Hospital of Kunming were selected as study samples. Their hospitalization time ranged from February 2018 to February 2019. The 51 patients were included in the experimental group, and another 51 women who underwent physical examination at The First Hospital of Kunming in the same period were included in the control group. Deoxyribonucleic acid and MTFR genetic polymorphism testing were performed in each group. The association between MTHFR gene polymorphism and granulomatous lobular mastitis was observed. RESULTS: There were significant differences in genotype frequency and allele frequency of C/C and C/T between the experimental group and the control group (all P < 0.05). However, there was no significant difference in frequency of T/T genotype between the two groups (P > 0.05). In addition, there was no significant difference in genotype frequency and allele frequency of A/A, A/C and C/C between the two groups (P > 0.05). CONCLUSION: MTHFR gene C677T locus polymorphism is closely related to granulomatous lobular mastitis.

[Research on the combustion mechanism of asphalt and the composition of harmful gas based on infrared spectral analysis].

By using the Rosemount gas analyzer and the test platform of fixed bed built by carbon furnace, the harmful gaseous compositions and the release rules of asphalt and mortar under high temperature rate were analyzed quantitatively based on infrared spectral analysis technology. The results indicated that the combustion process of the asphalt and mortar can be approximately divided into two stages stage of primary volatile combustion, and stage of secondary volatile release combined with fixed carbon combustion in isothermal condition with high heating rate. The major gaseous products are CO2, CO, NO, NO2 and SO2. the volatile content is one of the key factors affecting the release rules of gaseous combustion products in asphalt, and reducing the volatile content in asphalt materials can effectively reduce the generation of gaseous combustion products, especially CO.