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The problem of inadequate connection between sea area management and land management related to sea reclamation projects has long been a sore point in marine management. In this study, the system and practical experience of sea reclamation projects management in Zhejiang Province on replacing sea area use right certificate to land use right certificate, planning and use control, use fee collection were sorted out, investigated and researched, the existing problems were analyzed, management suggestions were put forward. This study showed that the main problems in the connection between sea reclamation and land management were as follows: ① the land management indicators required for the replace of land use right certificates were insufficient; ② the use right value of the sea area and land were inconsistent; ③ planning and use control were not sufficiently connected; ④ the use fee collection standards were not unified. To standardize the connection between sea reclamation and land management, the following suggestions were put forward: ① coordinate land and sea planning and use control; ② establish the management system of sea reclamation project indicator (plan) ; ③ explore the value realization form of sea area use right; ④ improve the connection of sea area use fee and land use fee; ⑤ promote joint auction of sea area use right and land use right. This study can provide reference for the formulation of relevant policies.

Uninhabited island planning is the last level of China's island planning system and the most direct regulatory tool for the government to guide the protection and utilization of uninhabited island. This paper identified and defined the stakeholders of uninhabited island planning, on the basis of analyzing the concept and connotation of the stakeholders. According to the influence and interest attribute, stakeholders were divided into four categories: high influence and high interest, high influence and low interest, low influence and high interest, low influence and low interest. According to the classification, management strategies such as "close management", "satisfaction", "information access" and "minimum attention" were put forward in the paper. By defining, classifying and managing stakeholders of uninhabited islands planning, the complex interest relations of all parties could be clarified and the stakeholders could participate in the planning, reach a planning consensus, and make the uninhabited island planning more scientific and practical.

It is technically demanding and requires rich experience to insert the translaminar facet screw(TFS) via the paramedian mini-incision approach. It seems that it is easy to place the TFS using computer-assisted design and rapid prototyping(RP) techniques. However, the accuracy and safety of these techniques is still unknown. The aim of this study is to assess the accuracy and safety of translaminar facet screw placement in multilevel unilateral transforaminal lumbar interbody fusion using a rapid prototyping drill guide template system. A patient-matched rapid prototyping translaminar facet screw guide was examined in fourteen cadaveric lumbar spine specimens. A three-dimensional (3D) preoperative screw trajectory was constructed using spinal computed tomography scans, from which individualized guides were developed for the placement of translaminar facet screws. Following bone tunnel establishment, the 3D positioning of the entry point and trajectory of the screws was compared to the preoperative plan as found in the Mimics software.Among 60 trajectories eligible for assessment, no cases of clinically significant laminar perforation were found. The mean deviation between the planned and the actual starting points on spinous process was 1.22 mm. The mean tail and submergence angle deviation was found to be 0.68°and 1.46°, respectively. Among all the deviations, none were found to have any statistical significance. These results indicate that translaminar facet screw placement using the guide system is both accurate and safe.

Objective In this retrospective study, a modified measurement method was used to analyze cage migration during follow-up after unilateral instrumented transforaminal lumbar interbody fusion (TLIF) and identify associated factors. Methods We retrospectively evaluated 75 patients who had been treated with unilateral instrumented TLIF. Cage migration was quantitatively defined as anterior–posterior or lateral displacement of the cage. Results Five patients had significant cage migration (6.7%), but none developed severe neural symptoms during follow-up or underwent reoperation. The cages tended to migrate posteriorly or toward the side of surgery. The initial cage position and patient age were strongly associated with migration. Migration was less frequent when the cages were initially placed closer to the side of surgery. Patients of advanced age were more likely to develop anterior–posterior migration than were young patients. Conclusion Cage migration is related to the initial position of the cage. Particular attention is required when performing unilateral instrumented TLIF in patients of advanced age because they are most likely to develop cage migration. Quantification of cage migration is an effective method of exploring the associated factors.

Background: Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). Materials and Methods: 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X‑ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t‑test was used for comparison between the preoperative values and postoperative counterparts. P < 0.05 was considered to be statistically significant. Results: Among 50 patients, 22 received one level fusion and 28 two level’s, with corresponding operation time and estimated blood loss being approximately 90 min, 150 ml and 120 min, 200 ml, respectively. No severe complications happened perioperatively. The mean VAS (back, leg) scores dropped from (7.6, 7.5) preoperatively to (2.1, 0.6) at 12 months’ followup, ODI from 49.1 preoperatively to 5.6 and JOA score raised from 10.6 preoperatively to 28.5, all P < 0.001, suggesting of good clinical outcome. From the three‑dimensional reconstructed CT, 62 out of 70 segments displayed solid fusion with fusion rate of 88.6% at 12 months postoperatively. Conclusions: TLIF using uPS fixation plus cTLFS fixation is a safe, feasible and effective technique in the treatment of one or two level lumbar degenerative diseases short termly. [ABSTRACT FROM AUTHOR]

In current TLIF practice, the choice of the cage size is empirical and primarily depends on the case volume and experience of the surgeon. We used a self-made modified distractor handle in TLIF procedure with the goal of standardizing the intervertebral space tension and determining the proper cage size. [ABSTRACT FROM AUTHOR]