Comparison of Minimally Invasive Surgery Transforaminal Lumbar Interbody Fusion and TLIF for Treatment of Lumbar Spine Stenosis

Efficacy of lumbar decompression under large-channel spinal endoscope in elderly patients with segmental lumbar spinal stenosis

OBJECTIVE

The present study was conducted with an attempt to explore the overall efficacy of large-channel spinal endoscopy technology in elderly patients with segmental lumbar spinal stenosis.

METHODS

We included a total of 68 elderly patients with segmental lumbar spinal stenosis in our hospital from February 2021 to March 2023. The participants were randomly and equally distributed into the study group and the control group using a random number table method. The control group received the open lumbar decompression surgery, and the study group received the lumbar decompression under large-channel spinal endoscopy technology. We compared the surgical conditions of the two groups, including pain level, Oswestry Disability Index (ODI) score, and Japanese Orthopedic Association (JOA) score before surgery, 1 week after surgery, 3 months after surgery, and 1 year after surgery. In addition, we compared the efficacy and adverse reactions 1 year after surgery between the two groups.

RESULTS

Our findings revealed that the operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were significantly lower than those in the control group (p < 0.05). There was no statistically significant difference in the degree of pain between the two groups before surgery (p > 0.05), and the pain intensity of the study group was significantly lower than that of the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Similarly, preoperative ODI and JOA scores were not significantly different between the two groups (p > 0.05), while they were significantly lower in the study group than those in the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Before surgery, no significant difference was seen in therapeutic efficacy between the two groups (p > 0.05), whereas the efficacy was remarkably improved in the study group comparing to the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). All patients in this study were followed up for 10 to 16 months, with an average of 13.29 ± 1.28 months. The incidence of adverse reactions in the study group was significantly lower than that in the control group (p < 0.05).

CONCLUSIONS

Large-channel spinal endoscopy technology exerted promising results in elderly patients with segmental lumbar spinal stenosis, in terms of reducing the surgical time, intraoperative bleeding, postoperative drainage volume, and hospital stay. The approach also alleviated pain, reduced ODI and JOA scores, and restored lumbar function, with decreased incidence of adverse reactions, thereby promoting patient recovery. It is considered valid for wide clinical application.

Endoscopic Lumbar Interbody Fusion, Minimally Invasive Transforaminal Lumbar Interbody Fusion, and Open Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Network Meta-Analysis

STUDY DESIGN

network meta-analysis.

OBJECTIVE

To compare the clinical efficacy and safety of endoscopic lumbar interbody fusion (Endo-LIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and open transforaminal lumbar interbody fusion (OTLIF) in the treatment of lumbar degenerative diseases (LDDs).

METHOD

A literature search was conducted in the PubMed, Embase, and Cochrane Library databases. Studies comparing Endo-LIF, MIS-TLIF and OTLIF published from September 2017 to September 2022 for the treatment of LDD were retrieved. Data were extracted from preset clinical outcome measures, including operation time, estimated intraoperative estimated blood loss (EBL), length of hospital stay (LOS), complications, visual analog scale (VAS) score, Oswestry disability index (ODI) score, etc.

RESULT

Thirty-one studies with 3467 patients were included in this study. Network meta-analysis showed that in the comparison of the 3 procedures, Endo-LIF was superior to MIS-TLIF and OTLIF in terms of reducing EBL, LOS, time to ambulation, and VAS score of back pain. MIS-TLIF was superior to Endo-LIF in terms of ODI improvement, and OTLIF required the shortest intraoperative fluoroscopy time. There was no significant difference in operative time, complication rate, fusion rate, VAS score of leg pain, or JOA score among the 3 procedures.

CONCLUSION

Endo-LIF, MIS-TLIF and OTLIF each have their own advantages and disadvantages and show similar results in many respects, except for better early outcomes achieved with the more minimally invasive procedure.

Clinical comparison of unilateral biportal endoscopic transforaminal lumbar interbody fusion verse 3D microscope-assisted transforaminal lumbar interbody fusion in the treatment of single-segment lumbar spondylolisthesis with lumbar spinal stenosis: a retrospective study with 24-month follow-up

OBJECTIVE

To explore the safety and the mid-term efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and 3D microscope-assisted transforaminal lumbar interbody fusion (MMIS-TLIF) for treating single-segment lumbar spondylolisthesis with lumbar spinal stenosis (DLS-LSS).

METHODS

The clinical data of 49 patients who underwent UBE-TLIF or MMIS-TLIF in our hospital were retrospectively analyzed, including 26 patients who underwent the UBE-TLIF and 23 patients who underwent the MMIS-TLIF. The demographic and perioperative outcomes of patients before and after surgery were reviewed. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical outcomes of patients before surgery and at 1, 3, 6, 12 and 24 months after surgery. The lumbar lordosis angle (LL), disc height (DH) and lumbar intervertebral fusion rate were assessed before surgery and at the last follow-up.

RESULTS

The VAS and ODI scores of the two groups were improved compared with those before surgery. The ODI of UBE-TLIF group was lower than that of MMIS-TLIF group at 1, 3, 6, and 12 months after surgery, and there were no significant differences between the two groups at other time points (P > 0.05). There were no significant differences in VAS between the two groups at each time point (P > 0.05). However, the UBE-TLIF group had more advantages in blood loss and hospital stay. The complications between the UBE-TLIF group (11.54%) and the MMIS-TLIF group (17.39%) were comparable (P > 0.05). Radiographic outcomes showed that the LL and DH of the two groups were improved compared with those before surgery, and the difference before and after surgery was not significant (P > 0.05). The fusion rate was 96.2% in the UBE-TLIF group and 95.7% in the MMIS-TLIF group. There was no significant difference in the fusion rate between the two groups (P > 0.05).

CONCLUSIONS

Both UBE-TLIF and MMIS-TLIF have favorable outcomes for treating single-segment DLS-LSS. Both groups have the advantages of clear surgical vision, high surgical efficiency, and favorable mid-term efficacy. In addition, compared with MMIS-TLIF, UBE-TLIF causes less intraoperative bleeding and faster postoperative recovery.

Different lumbar fusion techniques for lumbar spinal stenosis: a Bayesian network meta-analysis

OBJECTIVE

To comprehensively compare and assess the effects of different lumbar fusion techniques in patients with lumbar spinal stenosis (LSS).

METHODS

PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched up to December 24, 2022 in this network meta-analysis. Outcomes were pain (pain, low back pain, and leg pain), Japanese Orthopaedic Association (JOA), Oswestry Disability Index (ODI), complications, reoperation, and fusion. Network plots illustrated the direct and indirect comparisons of different fusion techniques for the outcomes. League tables showed the comparisons of any two fusion techniques, based on both direct and indirect evidence. The efficacy of each fusion technique for LSS was ranked by rank probabilities.

RESULTS

Totally 29 studies involving 2,379 patients were eligible. For pain, percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) was most likely to be the best technique, followed by minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), extreme lateral interbody fusion (XLIF), and transforaminal lumbar interbody fusion (TLIF). Percutaneous endoscopic posterior lumbar interbody fusion (Endo-PLIF) had the greatest likelihood to be the optimal technique for low back pain, followed sequentially by MIS-TLIF, minimally invasive posterior lumbar interbody fusion (MIS-PLIF), XLIF, Endo-TLIF, TLIF, oblique lumbar interbody fusion (OLIF), posterior lumbar interbody fusion (PLIF), and posterolateral lumbar fusion (PLF). MIS-PLIF was ranked the most effective technique concerning leg pain, followed by Endo-TLIF, MIS-TLIF, TLIF, Endo-PLIF, PLIF, OLIF, PLF, and XLIF. As regards JOA scores, Endo-TLIF had the maximum probability to be the best technique, followed by MIS-TLIF and TLIF. Endo-PLIF had the greatest likelihood to be the optimum technique for complications, followed by TLIF, MIS-TLIF, Endo-TLIF, OLIF, and XLIF.

CONCLUSION

Minimally invasive fusion techniques may be effective in the treatment of LSS, compared with traditional techniques. Minimally invasive techniques were likely non-inferior with regards to postoperative complications.

Study on the Mechanism of Pathological Recognition Based on Bioelectrical Impedance Spectrum to the Elbow Joint

The elbow joint is prone to stiffness and adhesion after trauma or surgery. High-energy trauma easily led to loss of mobility of the elbow joint. Mild trauma can also cause stiffness in the elbow joint. In order to investigate the pathogenesis of stiffness and adhesion in elbow joint, a feedback-type elbow joint control system based on network is proposed in this paper. The simulation results show that it has significant differences in elbow bioelectrical impedance in patients with elbow trauma, and this new method realizes the control strategy of converting the patient’s elbow joint pathological information into elbow joint orthosis control information.

Study on Intelligent Traditional Chinese Medicine Fumigation for Treating Lumbar Intervertebral Disc Herniation Based on Medical Big Data Mining

With the improvement of the traditional Chinese medicine fumigation (TCMF), more and more people are studying lumbar intervertebral disc herniation (LIDH) by TCMF. In order to clarify the thermodynamic mechanism of TCMF to LIDH and provide a model reference for individualized diagnosis, the lower control system is compiled by the microprocessor, and the upper control system is compiled by computer technology of VB. In this new system, the medical information of patients is recorded in the databases by the upper control system, and clinical diagnosis and treatment experience are packaged in the lower control system. The simulation results and clinical examples show that the new control system of TCMF has better clinical efficacy for LIDH patients, which not only effectively improves the pain symptoms of LIDH patients but is also economical and safe.

Detection and Diagnostic Value of Cytokines in Serum of Children with Acute Viral Encephalitis

Acute viral encephalitis is one of the serious infectious diseases. In order to analyze the diagnostic efficacy of serum procalcitonin (PCT), C-reactive protein (CRP), and S100B protein in acute viral encephalitis, a total of 100 children with acute viral encephalitis from July 2019 to December 2021 are selected and included in the viral encephalitis group. The results show that S100B protein model has high specificity and sensitivity and is simple to operate. It provides new ideas and directions for differential diagnosis, improvement, and optimization of relevant clinical diagnosis and treatment schemes and has high clinical value.

Efficacy of Shuanghe Jiyu Decoction in 126 Patients with Bone Marrow Suppression

Bone marrow suppression is a common complication of chemotherapy. In order to observe the effects of Shuanghe Jiyu decoction on peripheral white blood cells (WBC), hemoglobin (Hb), and platelet (PLT) in patients with bone marrow suppression, a total of 126 patients with bone marrow suppression were given at least three consecutive cycles of chemotherapy. The results show that among 126 patients with bone marrow suppression, 16 achieved marked efficacy and 100 achieved moderate efficacy. The overall effective rate is 92.06%. Moreover, the symptoms of bone marrow suppression are mitigated. No adverse events are reported during the treatment.

Analysis of the Efficacy and Safety of Pulpitis Treated with Different Root Canal Flushing Fluids Based on VAS and Temporomandibular Joint Function

Pulpitis is one of the common diseases indicated by the department of stomatology that is located in the tooth and contains abundant nerve vessels. In order to evaluate the pain degree and functional recovery of patients after treatment by visual analogue pain scale (VAS) and temporomandibular joint function score, a retrospective analysis was performed on 128 patients diagnosed with pulpitis who received root canal treatment in the department of stomatology from January 2020 to March 2021. The results show that 3%NaClO combined with 0.9% sodium chloride injection can effectively relieve the pain degree of patients after treatment, and the antibacterial effect is significantly better than 3%H2O2 combined with 0.9% normal saline. Meanwhile, it can effectively improve the temporomandibular joint function and reduce the recurrence rate, which has good clinical application value.

Analysis of the Effect of DPL Combined with Clarithromycin in the Therapy and Improvement of Rosacea

Rosacea is a chronic inflammatory skin disease with a high incidence, and it leads to negative emotions such as inferiority complex, increased psychological pressure, and a greatly reduced quality of life. In order to investigate the clinical efficacy of DPL combined with clarithromycin in the treatment and improvement of rosacea. 86 patients with rosacea were selected and randomly divided into the control group and study group according to the random number table method. The results show that the combination of DPL and clarithromycin in the treatment of rosacea patients can effectively improve the clinical symptoms of patients, improve the therapeutic effect, and the incidence of adverse reactions is low, which ensures that the patients have a good prognosis, which is worthy of clinical application.

Investigation of the Immunoprotective Effect of Zinc on Ovalbumin Induced BALB/C Male Mice Based on NF-KB Signaling Pathway

Allergic rhinitis is one of the common chronic inflammatory diseases of the nasal mucosa. In order to investigate the effect of zinc on ovalbumin induced allergic rhinitis in BALB/C male mice based on NF-KB signaling pathway, thirty BALB/C male mice are randomly divided into three groups: control group, ovalbumin induced allergic rhinitis asthma group and zinc intervention group. The experimental results show that Zinc supplementation in allergic asthma mice with allergic rhinitis correct the immune response of TH2 cells by inhibiting THE NF-KB signaling pathway, reduce the infiltration of inflammatory cells into lung nasal tissue, and reduce airway co-hyperreactivity to improve the clinical symptoms of asthma and play an immune protective role.

WeChat-Based Comprehensive Education on Egg White Protein Intake for Patients Undergoing Peritoneal Dialysis: A Combined Prospective and Retrospective Study

Protein malnutrition is a well-described complication of peritoneal dialysis (PD), a standard mode of treatment for end-stage renal disease (ESRD), and contributes to morbidity, treatment failure, and mortality. To assess the usefulness of WeChat-based education for ensuring optimal protein intake through the consumption of egg white protein, 140 young and middle-aged patients undergoing PD are assigned to either the intervention group or the control group. The results show that reinforcing comprehensive PD education using WeChat can improve nutritional parameters, clinical parameters, and quality of life.

TNFAIP6 Promotes Gastric Carcinoma Cell Invasion via Upregulating PTX3 and Activating the Wnt/β-Catenin Signaling Pathway

Tumor metastasis is a fundamental cause of the poor prognosis of gastric carcinoma (GC). In order to study the problems affecting metastasis and recurrence of gastric cancer, the paper expose that TNF alpha induced protein 6 (TNFAIP6) is aberrantly overexpressed in GC, and patients with high-TNFAIP6 levels exhibited inferior overall survival. Mechanistically, overexpression of TNFAIP6 raised β-catenin ectopic nuclear distribution and activated the Wnt/β-catenin signal pathway. The experimental results show that TNFAIP6 facilitates the aggressive potential of GC cells through modulating PTX3 expression.

Analysis of Interventional Application Effect of Ultrasound-Guided QLB and TAPB in the Treatment and Analgesia of Patients Undergoing Laparoscopic Colorectal Surgery

Colorectal cancer is a common malignant tumor of the digestive system. In order to study the clinical efficacy of ultrasound-guided QLB and TAPB in the treatment and postoperative analgesia of patients undergoing laparoscopic colorectal surgery. A total of 96 patients undergoing laparoscopic colorectal surgery from January 2021 to January 2022 are selected as the study subjects. The results show that ultrasound-guided QLB and TAPB therapy have good analgesic effects in patients undergoing laparoscopic colorectal surgery, and QLB treatment and postoperative analgesic effect are better than TAPB.

Linalool Impress Colorectal Cancer Deterioration by Mediating AKT/mTOR and JAK2/STAT3 Signaling Pathways

Colorectal cancer (CRC) is one of the more common causes of cancer death worldwide. Chemotherapy is effective in the treatment of CRC, but it can produce a range of adverse effects that can significantly reduce the quality of life of CRC patients. The selection of drugs that are effective in treating CRC with few adverse effects is now an important task and is aimed at prolonging the survival of patients and improving their prognosis. In this study, CRC cells were treated with linalool using CRC cell lines as the study subjects, and cell viability, apoptosis, and cell migration were observed after treatment. Previous studies have demonstrated the therapeutic effects of linalool on CRC and its ability to inhibit CRC progression by modulating the AKT/mTOR and JAK2/STAT3 pathways.

Effect of New Nursing Team Management Mode on Self-Efficacy, Compliance, and Quality of Life of Patients with Chronic Kidney Disease and Its Chain Mediating Effect

Chronic kidney disease (CKD) is one of the serious diseases that lead to a series of metabolic disorders, and its process is irreversible. In order to explore the intervention effect of the new nursing team intervention program in patients with CKD, 100 patients with CKD from May 2020 to May 2021 were randomly selected in this paper and divided into the traditional group and the combined group. The comparison of clinical nursing shows that the new nursing team management model improves the compliance, self-management efficiency, and quality of life of patients with CKD, which is worth recommending in nursing practice.

Investigation of the Disparities in Ultrasound Imaging Features of miR-323, miR-409-3p, and VEGF Expression Scales in Different Clinicopathological Features of Prostate Carcinoma and Their Correlation with Prognosis

Prostate carcinoma (PC) is a disease of the male genitourinary system and a relatively common malignant tumor. In order to investigate the disparities in the expression of microRNA-323 (miR-323), microRNA-409-3p (miR-409-3p), and vascular endothelial growth factor (VEGF) in prostate carcinoma with different clinicopathological features and analyze their correlation with prognosis. Thirty-two sufferers with prostate carcinoma and forty-three sufferers with benign prostatic hyperplasia are included. The results show that the detection of miR-323, miR-409-3p, and VEGF scales can provide reference value for clinical guidance of prostate carcinoma prognosis.

Integrated Analysis of lncRNA-miRNA-mRNA ceRNA Network in Mixed Dry Eye Disease

In order to investigate the relationship between inflammation and lncRNA in mixed dry eye disease (DED), this study establishes competitive endogenous RNA (ceRNA) network in mixed DED. Microarray analysis of cornea from mixed DED mice is performed to screen for differences in lncRNA and target genes, and miRNA bioinformatics were predicted based on the ceRNA hypothesis. The ceRNA network, which consists of 96 relationship pairs, is constructed using the top 10 upregulated lncRNAs and all upregulated mRNAs and two pairs of lncRNA-miRNA-mRNA pairs (NONMMUT047964.2-miR-671-5p-Egr-1andNONMMUT054540.2-miR-1934-5p-Grm2) are selected for RT-qRCR verification in mouse corneal epithelial cells under high osmotic pressure and the samples for microarray. Meanwhile, mouse corneal epithelial cell lines (MCECs), transfected siRNA of NONMMUT047964.2 under high osmotic pressure, shows a decrease in apoptosis rate and a decrease in expression of IL-1β and IL-6. The experimental results show that the NONMMUT047964.2-miR-671-5p-Egr-1 axis may regulate the inflammation and promote the apoptosis of corneal epithelial cells under hypertonic condition.

The Study of Maslow's Hierarchy of Needs Theory in the Doctor-Nurse Integration Teaching Method on Clinical Interns

The student's attitude towards the doctor-nurse integrated teaching model and Maslow's hierarchy of needs theory is an important topic in clinical teaching. In this study, choosing 134 intern doctors and practice nurses who intern from January to December 2020. 67 students are selected as the control group, and the traditional interns teaching mode is adopted. 67 students are selected as the experimental group and Maslow's hierarchy of needs theory to apply in the doctor-nurse integrated teaching mode. The results show that the doctor-nurse integrated teaching model are accepted by most students, and the application of Maslow's hierarchy of needs theory in the clinical interns has advantages over the traditional model.

Study of Subfascial Endoscopic Perforator Surgery Combined with Endovenous Laser Treatment in the Treatment of Great Saphenous Varicose Veins

Great saphenous varicose vein (GSVV) is a venous reflux disease of the lower extremity. In order to explore the clinical effect of subfascial endoscopic perforator surgery (SEPS) with endovenous laser treatment (EVLT) in the treatment of GSVV, 80 patients who underwent unilateral saphenous varicose surgery are analyzed. The operation results show that the patients who used SEPS + EVLT have less operation time and mean blood loss, shorter postoperative active time and hospitalization stay, better curative effect, and higher notch aesthetics (P < 0.05). SEPS combined with EVLT has a remarkable curative effect in the treatment of saphenous varicose veins of lower extremity, which can significantly shorten the hospitalization time of patients and improve the coagulation index and stress index.

Effects of the Femoral Nerve Block and Adductor Canal Block on Tourniquet Response and Postoperative Analgesia in Total Knee Arthroplasty

Tourniquet has emerged as an important role in surgical procedures, sixty patients undergoing elective total knee arthroplasty are randomly divided into the nerve block group and adductor duct block group in this paper. The changes of mean arterial pressure (MAP) and heart rate (HR) at different time points during operation, the changes of VAS scores at resting pain and exercise pain, and the changes of quadriceps femur muscle strength at different time points after operation are observed in 2 groups. The experimental results show that compared with adductor duct block, femoral nerve block can better relieve the intraoperative tourniquet reaction without affecting the postoperative analgesic effect and the muscle strength of quadriceps femurs.