Real-Time Monitoring of Tyrosine Hydroxylase Activity with a Ratiometric Fluorescent Probe.

Parkinson's disease (PD) represents the second most widespread neurodegenerative disease, and early monitoring and diagnosis are urgent at present. Tyrosine hydroxylase (TH) is a key enzyme for producing dopamine, the levels of which can serve as an indicator for assessing the severity and progression of PD. This renders the specific detection and visualization of TH a strategically vital way to meet the above demands. However, a fluorescent probe for TH monitoring is still missing. Herein, three rationally designed wash-free ratiometric fluorescent probes were proposed. Among them, TH-1 exhibited ideal photophysical properties and specific dual-channel bioimaging of TH activity in SH-SY5Y nerve cells. Moreover, the probe allowed for in vivo imaging of TH activity in zebrafish brain and living striatal slices of mice. Overall, the ratiometric fluorescent probe TH-1 could serve as a potential tool for real-time monitoring of PD in complex biosystems.

C3N5-based nanomaterials and their applications in heterogeneous catalysts, energy harvesting, and environmental remediation.

Over the past few decades, the global reliance on fossil fuels and the exponential growth of human population have escalated global energy consumption and environmental issues. To tackle these dual challenges, metal catalysts, in particular precious metal ones, have emerged as pivotal players in the fields of environment and energy. Among the numerous metal-free and organic catalyst materials, C3N5-based materials have a major advantage over their carbon nitride (CxNy) counterparts owing to the abundant availability of raw materials, non-toxicity, non-hazardous nature, and exceptional performance. Although significant efforts have been dedicated to synthesising and optimising the applicable properties of C3N5-based materials in recent years, a comprehensive summary of the immediate parameters of this promising material is still lacking. Given the rapid development of C3N5-based materials, a timely review is essential for staying updated on their strengths and weaknesses across various applications, as well as providing guidance for designing efficient catalysts. In this study, we present an extensive overview of recent advancements in C3N5-based materials, encompassing their physicochemical properties, major synthetic methods, and applications in photocatalysis, electrocatalysis, and adsorption, among others. This systematic review effectively summarises both the advantages and shortcomings associated with C3N5-based materials for energy and environmental applications, thus offering researchers focussed on CxNy-materials an in-depth understanding of those based on C3N5. Finally, considering the limitations and deficiencies of C3N5-based materials, we have proposed enhancement schemes and strategies, while presenting personal perspectives on the challenges and future directions for C3N5. Our ultimate aim is to provide valuable insights for the research community in this field.

Internal Vanadium Doping and External Modification Design of P2-Type Layered Mn-Based Oxides as Competitive Cathodes toward Sodium-Ion Batteries.

P2-type layered manganese-based oxides have attracted considerable interest as economical, cathode materials with high energy density for sodium-ion batteries (SIBs). Despite their potential, these materials still face challenges related to sluggish kinetics and structural instability. In this study, a composite cathode material, Na0.67 Ni0.23 Mn0.67 V0.1 O2 @Na3 V2 O2 (PO4 )2 F was developed by surface-coating P2-type Na0.67 Ni0.23 Mn0.67 V0.1 O2 with a thin layer of Na3 V2 O2 (PO4 )2 F to enhance both the electrochemical sodium storage and material air stability. The optimized Na0.67 Ni0.23 Mn0.67 V0.1 O2 @5wt %Na3 V2 O2 (PO4 )2 F exhibited a high discharge capacity of 176 mA h g-1 within the 1.5-4.1 V range at a low current density of 17 mA g-1 . At an increased current density of 850 mA g-1 within the same voltage window, it still delivered a substantial initial discharge capacity of 112 mAh g-1 . These findings validate the significant enhancement of ion diffusion capabilities and rate performance in the P2-type Na0.67 Ni0.33 Mn0.67 O2 material conferred by the composite cathode.

[Progress in treatment of high-grade spondylolisthesis].

Objective: To review the research progress in the treatment of high-grade spondylolisthesis (HS), in order to provide a reference for clinical treatment decision-making. Methods: The literature related to the treatment of HS at home and abroad in recent years was widely reviewed. The methods of conservative treatment, in situ fusion, and spondylolisthesis reduction were analyzed and summarized. Results: Surgical treatment is the main treatment of HS, but which method is the best is still controversial. The advantages, disadvantages, and applicability of various operations are also different, so individualized analysis is needed in clinic. Conclusion: The treatment plan of HS needs to be considered comprehensively according to the individual condition of the patient. It will be an important research direction to further compare the existing treatment methods and develop more safe and effective new technology.

Therapeutic factors and biomaterial-based delivery tools for degenerative intervertebral disc repair.

Intervertebral disc degeneration (IDD) is the main cause of low back pain (LBP), which significantly impacts global wellbeing and contributes to global productivity declines. Conventional treatment approaches, encompassing conservative and surgical interventions, merely serve to postpone the advancement of IDD without offering a fundamental reversal. Consequently, there is an urgent demand for an effective approach to prevent the progression of IDD. Recent investigations focusing on the treatment of IDD utilizing diverse bioactive substances integrated within various biomaterials have exhibited promising outcomes. Various bioactive substances, encompassing conventional small molecule drugs, small molecule nucleic acids, and cell therapies, exhibit distinct capacities for repairing IDD. Additionally, various biological material delivery systems, such as nano micelles, microspheres, and hydrogels, possess diverse biological and release characteristics. Consequently, these diverse materials and drugs hold promise for advancing the treatment of IDD. This article aims to provide a concise overview of the IDD process and investigate the research advancements in biomaterials and bioactive substances for IDD treatment, delving into their mechanisms.

Ru doped NiMoO4 nanoarray as a high-efficiency electrocatalyst for nitrite reduction to ammonia.

The electrocatalytic reduction of nitrite to recyclable ammonia (NH3) is essential to maintain nitrogen balance and meet growing energy requirements. Herein, we report that Ru doped honeycomb NiMoO4 nanosheet with copious oxygen vacancies grown on nickel foam substrate has been prepared by a facile hydrothermal synthesis and immersion process, which can act as an efficient electrocatalyst for NH3 synthesis by reduction of nitrite. By optimizing the concentration of RuCl3 solution, 0.01Ru-NiMoO4/NF possesses excellent NO2-RR performance with NH3 yield of 20249.17 ± 637.42 µg h-1 cm-2 at -0.7 V and FE of 95.56 ± 0.72 % at -0.6 V. When assembled into a Zn-NO2- battery, it provides a remarkable level of power density of 13.89 mW cm-2, outperforming the performance of virtually all previous reports. The efficient adsorption and activation of NO2- over Ru-doped NiMoO4 with oxygen vacancy have been verified by density functional theory calculations, as well as the possible reaction pathway.

High-efficiency electrocatalytic nitrite-to-ammonia conversion on molybdenum doped cobalt oxide nanoarray at ambient conditions.

Electrochemical conversion of nitrite (NO2-) contaminant to green ammonia (NH3) is a promising approach to achieve the nitrogen cycle. The slow kinetics of the complex multi-reaction process remains a serious issue, and there is still a need to design highly effective and selective catalysts. Herein, we report that molybdenum doped cobalt oxide nanoarray on titanium mesh (Mo-Co3O4/TM) acts as a catalyst to facilitate electroreduction of NO2- to NH3. Such a catalyst delivers an extremely high Faradaic efficiency of 96.9 % and a corresponding NH3 yield of 651.5 µmol h-1 cm-2 at -0.5 V with strong stability. Density functional theory calculations reveal that the introduction of Mo can induce the redistribution of electrons around Co atoms and further strengthen the adsorption of NO2-, which is the key to facilitating the catalytic performance. Furthermore, the assembled battery based on Mo-Co3O4/TM suggests its practical application value.

Intraoperative Protection of Pharyngeal Autonomic Nerves: Preventing Dysphagia After Anterior Cervical Decompression and Fusion Surgery.

OBJECTIVE: The study aims to investigate whether intraoperative protection of the pharyngeal autonomic nerve can effectively reduce the incidence of postoperative dysphagia following anterior cervical decompression and fusion surgery (ACDF). METHODS: A retrospective analysis was conducted on 130 cases that underwent ACDF from January 2018 to June 2022 at our hospital. Divided into nonautonomic neuroprotection (NANP) group and autonomic neuroprotection group based on whether receive protective measures for the pharyngeal autonomic nerve during surgery. General data were recorded and compared between the 2 groups. Postoperative outcomes were evaluated using Neck Disability Index, Japanese Orthopaedics Association (JOA) score, and JOA improvement rate. The incidence and severity of postoperative dysphagia were assessed using Bazaz dysphagia assessment criteria and swallowing-quality of life questionnaire. RESULTS: There were no significant differences in general data (P > 0.05). The average operation time and intraoperative blood loss also showed no significant differences (P > 0.05). Both groups showed significant improvements in Neck Disability Index and JOA scores at all follow-up time points compared to preoperative scores (P < 0.01). The incidence of postoperative dysphagia in the autonomic neuroprotection group was significantly lower than that in the NANP group at all follow-up time points (P < 0.05). Both group showed a significant reduction in scores 3 days postoperatively compared to preoperative scores (P < 0.01), and the NANP group also showed significant reductions in scores at 3 month and 1 year postoperative follow-up time points compared to preoperative scores (P < 0.01). CONCLUSIONS: The adoption of pharyngeal autonomic nerve protective measures during ACDF can effectively lower the probability of postoperative dysphagia.

Channel-assisted cervical key hole technology combined with ultrasonic bone osteotome versus posterior percutaneous endoscopic cervical foraminotomy: a clinical retrospective study.

PURPOSE: The search for more effective and safe treatment methods for cervical spondylotic radiculopathy (CSR) has led to the rapid development and increasing popularity of minimally invasive posterior cervical foraminotomy (MI-PCF). This study aims to compare two important approaches for MI-PCF surgery: the channel-assisted cervical key hole technology combined with ultrasonic bone osteotome (CKH-UBO) and posterior percutaneous endoscopic cervical foraminotomy (PPECF). METHODS: Data from patients treated with single-level CKH-UBO (n = 35) or PPECF (n = 40) were analyzed. Clinical outcomes, including visual analogue scale (VAS) scores for neck and arm pain, Neck Disability Index (NDI), and modified Macnab criteria, were assessed preoperatively, as well as at three days, three months, and one year postoperatively. RESULTS: The percentages of patients with excellent and good outcomes were 97.14% and 92.5%, respectively. The average surgical time in the CKH-UBO group was significantly shorter than in the PPECF group (p < 0.001), while the average incision length in the PPECF group was significantly smaller than in the CKH-UBO group. There were no significant differences between the two groups in terms of blood loss, hospital stay, and clinical outcomes at three days, three months, and 12 months postoperatively. CONCLUSION: CKH-UBO can achieve the same surgical outcomes as PPECF for the treatment of CSR. However, CKH-UBO saves more time but requires patients to undergo larger incisions.

Regulating inflammation and apoptosis: A smart microgel gene delivery system for repairing degenerative nucleus pulposus.

The progression of intervertebral disc degeneration (IDD) is attributed to the gradual exacerbation of cellular apoptosis and impaired extracellular matrix (ECM) synthesis, both of which are induced by progressive inflammation. Therefore, it is crucial to address the inflammatory microenvironment and rectify the excessive apoptosis of nucleus pulposus cells (NPCs) to achieve intervertebral disc (IVD) regeneration. In this study, we devised a smart microgel gene delivery system that incorporates functionalized gene nanoparticles (NPs) for the purpose of IVD regeneration. siGrem1 was loaded into the NPs to enhance their antiapoptotic ability and protective effects. Furthermore, the encapsulation of HADA further endows the NPs (referred to as HSGN) with targeted delivery and anti-inflammatory effects, as well as reactive oxygen species (ROS) scavenging capacities. To create an microenvironment-responsive microgel system, phenylboronic acid-functionalized microspheres (referred to as M.S.) were fabricated and dynamically loaded with the HSGN. This microgel system (MHSGN), which is highly biocompatible, enables the sustained release of siGrem1, effectively modulating inflammation, scavenging ROS, and alleviating apoptosis in NPCs. These multifunctional capabilities promote the restoration of metabolic homeostasis within the nucleus pulposus ECM, ultimately leading to delayed IDD.

Manipulating the crystal plane angle within the primary particle arrangement for the radial ordered structure in a Ni-rich cathode.

Ni-rich cathodes with a radial ordered microstructure have been proved to enhance materials' structural stability. However, the construction process of radial structures has not yet been clearly elaborated. Herein, the formation process of radial structures induced by different doped elements has been systematically investigated. The advanced Electron Back Scatter Diffraction (EBSD) characterization reveals that W-doped materials are more likely to form a low-angle arrangement between crystal planes of the primary particles and exhibit twin growth during sintering than a B-doped cathode. The corresponding High Angle Annular Dark Field-Scanning Transmission Electron Microscopy (HAADF-STEM) analysis further proves that the twin growth induced by W doping can promote the migration of Li+. Simultaneously, the W-doped sample reduces the (003) plane surface energy and promotes the retention of the crystal plane, which can effectively alleviate the structural degradation caused by Li+ (de)intercalation. At a cut-off voltage of 4.6 V, the W-doped cathode displays a capacity retention rate of 94.1% after 200 cycles at 1C. This work unveils the influence of different element doping on the structure from the perspective of crystal plane orientation within primary particles and points out the importance of the exposure and orientation of the crystal plane of the particles.

Application and development of hydrogel biomaterials for the treatment of intervertebral disc degeneration: a literature review.

Low back pain caused by disc herniation and spinal stenosis imposes an enormous medical burden on society due to its high prevalence and refractory nature. This is mainly due to the long-term inflammation and degradation of the extracellular matrix in the process of intervertebral disc degeneration (IVDD), which manifests as loss of water in the nucleus pulposus (NP) and the formation of fibrous disc fissures. Biomaterial repair strategies involving hydrogels play an important role in the treatment of intervertebral disc degeneration. Excellent biocompatibility, tunable mechanical properties, easy modification, injectability, and the ability to encapsulate drugs, cells, genes, etc. make hydrogels good candidates as scaffolds and cell/drug carriers for treating NP degeneration and other aspects of IVDD. This review first briefly describes the anatomy, pathology, and current treatments of IVDD, and then introduces different types of hydrogels and addresses "smart hydrogels". Finally, we discuss the feasibility and prospects of using hydrogels to treat IVDD.

MOF-on-MOF-Derived Ultrafine Fe2P-Co2P Heterostructures for High-Efficiency and Durable Anion Exchange Membrane Water Electrolyzers.

The alkaline hydrogen evolution reaction (HER) in an anion exchange membrane water electrolyzer (AEMWE) is considered to be a promising approach for large-scale industrial hydrogen production. Nevertheless, it is severely hampered by the inability to operate tolerable HER catalysts consistently under low overpotentials at ampere-level current densities. Here, we develop a universal ligand-exchange (MOF-on-MOF) modulation strategy to synthesize ultrafine Fe2P and Co2P nanoparticles, which are well anchored on N and P dual-doped carbon porous nanosheets (Fe2P-Co2P/NPC). In addition, benefiting from the downshift of the d-band center and the interfacial Co-P-Fe bridging, the electron-rich P site is triggered, which induces the redistribution of electron density and the swapping of active centers, lowering the energy barrier of the HER. As a result, the Fe2P-Co2P/NPC catalyst only requires a low overpotential of 175 mV to achieve a current density of 1000 mA cm-2. The solar-driven water electrolysis system presents a record-setting and stable solar-to-hydrogen conversion efficiency of 20.36%. Crucially, the catalyst could stably operate at 1000 mA cm-2 over 1000 h in a practical AEMWE at an estimated cost of US$0.79 per kilogram of H2, which achieves the target (US$2 per kg of H2) set by the U.S. Department of Energy (DOE).

Clinical efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of II° lumbar isthmic spondylolisthesis: A retrospective cohort study.

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is not suitable for high-grade isthmic spondylolisthesis, whether MIS-TLIF can treat II° lumbar isthmic spondylolisthesis (IS) is still controversial. This retrospective cohort study compared the clinical efficacy of MIS-TLIF and open transforaminal lumbar interbody fusion (OPEN-TLIF) in the treatment of II° lumbar IS. From January 2017 to January 2023, 101 patients with II° lumbar IS were diagnosed in our hospital and underwent surgical treatment, of which 53 received MIS-TLIF surgery and 48 received OPEN-TLIF surgery. The operation time, blood loss and surgical complications were compared between the 2 groups. The pain, function, reduction rate and fusion rate of the patients were evaluated during follow-up. The amount of intraoperative blood loss, postoperative drainage, and postoperative hospital stay in the MIS-TLIF group were significantly lower than those in the OPEN-TLIF group were (P < .01). In the MIS-TLIF group, there were 1 case of dural sac injury and 3 cases of lower limb paralysis. The complication rate of MIS-TLIF was lower than the OPEN-TLIF group (P = .032). In the visual analog scale score of low back pain, the MIS-TLIF group was lower than the OPEN-TLIF group after operation and at the last follow-up. There were no significant differences in postoperative leg pain score, slippage rate, and fusion rate between the 2 groups. Compared with OPEN-TLIF, MIS-TLIF has the advantages of better low back pain relief, less trauma, less bleeding and faster recovery, and is worthy of clinical promotion.

Clinical Outcomes of Isobar TTL System with Isthmic Bone Grafting and Pedicle Screw-Vertebral Plate Hook with Direct Repair of Defect for Lumbar Spondylolysis: A Matched-Pair Case Control Study.

OBJECTIVE: Although direct isthmic repair, such as PSVPH, did not affect the mobility of the fixed segment and adjacent segment, it has a relatively low rate of isthmic fusion compared with conventional fusion. The Isobar TTL dynamic internal fixation system has been widely used in clinical practice and has achieved satisfactory clinical results. However, the use of the Isobar TTL system in combination with direct isthmic repair for lumbar spondylolysis has rarely been reported. The aim of this study was to compare the clinical and radiologic outcomes between patients who underwent Isobar TTL system and PSVPH with direct repair of defect for lumbar spondylolysis. METHODS: Stepwise propensity score matching (PSM) for age and sex were performed to keep comparable clinical data between groups in this retrospective and matched-pair case control study. A total of 50 patients diagnosed with lumbar spondylolysis underwent surgical implantation of the Isobar TTL group (n = 25) or PSVPH group (n = 25) from June 2009 to June 2016. Clinical outcomes were assessed using the Oswestry disability index (ODI), and visual analog score (VAS). Radiographic evaluations included range of motion (ROM) and the disc heights of stabilized segment and adjacent segment, adjacent segment degeneration (ASD) and bony fusion. Three-dimensional reconstruction of lumbar CT scan was obtained to evaluate bone fusion of the isthmic at final follow-up. The independent Student's t test and chi-square test were applied to compare the differences between groups. RESULTS: A total of 25 patients from TTL group were matched to 25 patients in PSVPH group for age, sex, body mass index (BMI), defect side, spondylolisthesis meyerding, and follow-up duration. The intervertebral space height (IH) of stabilized segment at postoperative 1 week and final follow-up in the TTL group was higher than those in the PSVPH group, respectively (P = 0.030; P = 0.013). The ROM of stabilized segment at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P < 0.001). The bony fusion rate at the final follow-up was 88.0% (22/25 cages) in the TTL group and 80.0% (20/25 cages) in the PSVPH group. The ODI score at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P = 0.007). CONCLUSION: Overall, our data suggest that the Isobar TTL system outcomes are comparable to those in the PSVPH, with a similar high bony fusion rate as PSVPH, especially its wider indications as a new surgery.

A brush-like Cu2O-CoO core-shell nanoarray: an efficient bifunctional electrocatalyst for overall seawater splitting.

Herein, a brush-like Cu2O-CoO core-shell nanoarray on copper foam (Cu2O-CoO/CF) can achieve efficient oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) performance in alkaline seawater electrolyte. This Cu2O-CoO/CF shows overpotentials as low as 315 and 295 mV at 100 mA cm-2 for the OER and HER, respectively. Moreover, it could also be operated at 1.82 V with 100 mA cm-2 in a two-electrode electrolyzer and exhibits strong stability for at least 50 hours of electrolysis. The excellent performance and hierarchical structure advantages of Cu2O-CoO/CF provide new ideas for designing efficient seawater splitting electrocatalysts.

Identification and validation of a nomogram predicting cancer-specific survival for elderly patients with adult fibrosarcoma: a multicenter retrospective study.

Background: Due to the low incidence of adult fibrosarcoma (AFS), it is difficult for clinicians to assess cancer-specific survival (CSS) in elderly patients based on this study. The study aimed to develop nomograms capable of accurately predicting 3-, 5-, and 8-year CSS in patients over 40 years of age with AFS. Methods: Data were collected from The Surveillance, Epidemiology, and End Results (SEER) registry. 586 patients were included in this study. Univariate as well as multivariate Cox regression analyses were applied to identify independent risk factors. A nomogram was constructed and validated to predict the 3-, 5-, and 8-year CSS of patients. Results: Five variables including age, sex, stage, grade, and chemotherapy status were considered independent risk factors and were used to construct the nomogram. The nomogram was well validated. The C-indexes of the training cohort and the validation cohort are 0.766 and 0.780, respectively. In addition, the area under the curves for 3-, 5- and 8-year CSS are 0.824, 0.846 and 0.840 in the training cohort, 0.835, 0.806 and 0.829 in the validation cohort. Calibration curves were also plotted to show that predicted endings have a well fit for the true endings. Finally, decision curve analysis demonstrates that the nomogram can bring a high benefit to patients. Conclusion: We successfully constructed a highly accurate nomogram to predict the CSS of AFS patients at 3-, 5-, and 8 years. The nomogram can greatly help clinicians and patients with AFS.

Repair of degenerative nucleus pulposus by polyphenol nanosphere-encapsulated hydrogel gene delivery system.

Intervertebral disc degeneration (IDD) progresses due to local inflammatory response, gradually unbalanced anabolic/catabolic activity, and progressive functional impairment within the nucleus pulposus. Antagomir-21, a cholesterol-modified miRNA-21 inhibitor, has potential extracellular matrix (ECM) regenerative ability, but its application for IDD is limited by inadequate local delivery systems. An injectable hydrogel gene delivery system encapsulating a modified tannic acid nanoparticles (TA NPs) vector was engineered for on-demand and sustained delivery of antagomir-21 into the nucleus pulposus. After nucleus pulposus cell uptake, antagomir-21 was released from TA NPs and regulated the ECM metabolic balance by inhibiting the MAPK/ERK signaling pathway. TA NPs scavenged intracellular ROS and reduced inflammation by downregulating TNF-α expression. In vivo, synergistic anti-inflammatory effects and ECM regeneration effectively promoted therapeutic efficacy against IDD. This hydrogel gene delivery system represents a creative, promising strategy for IDD repair.

Percutaneous Full Endoscopic Lumbar Discectomy for Symptomatic Adjacent Segment Disease after Lumbar Fusion in Elderly Patients.

PURPOSE: Treatment of adjacent segment disease (ASD) is still controversial. The aim of this study was to evaluate the short-term efficacy and safety and to analyze the technical advantages, surgical approach, and indications of percutaneous full endoscopic lumbar discectomy (PELD) in the treatment of ASD after lumbar fusion in elderly patients. METHODS: A retrospective of 32 patients with symptomatic ASD were accepted for PELD from October 2017 to January 2020. All patients used the transforaminal approach and recorded the operation time and intraoperative conditions. Preoperative, 3, 12, 24 months of postoperative and at the last follow-up, the pain of back and leg of visual analog scale (VAS), Oswestry dysfunction index (ODI), and Japanese Orthopaedic Association Assessment Treatment Score (JOA) were performed, and the paired student's t test was used to the compare the continuous variables preoperatively and postoperatively. The clinical efficacy was evaluated according to MacNab standards. The lumbar MRI was performed to evaluate the decompression of the nerve roots, and the lumbar lateral and dynamic X-rays were performed to evaluate the stability of the surgical segment. RESULTS: A total of 32 patients were included in the study, including 17 males and 15 females. The follow-up time ranged from 24 to 50 months, with an average of (33.2 ± 8.1) months and an average operation time of (62.7 ± 28.1) minutes. Compared to preoperatively, the VAS score of the back and leg pain (p < 0.05), ODI (p < 0.05), and JOA (p < 0.05) postoperatively were significantly improved. At the last follow-up, according to the modified MacNab standard assessment, 24 cases were excellent, five cases were good, and three cases were fair, the excellent and good rate was 90.65%. As for complications, one case had a small rupture of the dural sac during the operation, which was found but not repaired during the operation, and one case recurred after the operation. At the last follow-up, there were three cases of intervertebral instability. CONCLUSION: PELD showed satisfactory short-term efficacy and safety in the management of ASD after lumbar fusion in elderly patients. Therefore, PELD might be an alternative choice for elderly patients with symptomatic ASD after lumbar fusion, but surgical indications must be strictly controlled.