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Background With the improvement of medical technology, the indications of spinal endoscopy technology are becoming more and more widespread. Percutaneous endoscopic posterior tranforaminal lumbar interbody fusion (Endo-P/TLIF) has been rapidly and widely used in lumbar spondylolisthesis combined with lumbar spinal stenosis, achieving certain efficacy in clinical observation. Compared with traditional fusion cages, height adjustable titanium fusion cage have better distraction effect and can effectively restore intervertebral space height, with obvious efficacy in Endo-P/TLIF surgery. Objective To investigate the application and clinical efficacy of Endo-P/TLIF combined with height adjustable titanium fusion cage in the treatment of lumbar spondylolisthesis with lumbar spinal stenosis. Methods The clinical data of 171 patients with lumbar spondylolisthesis with lumbar spinal stenosis treated at the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2019 to June 2021 were retrospectively analyzed. The included patients were divided into 35 cases in the Endo-P/TLIF+adjustable fusion cage group, 57 cases in the Endo-P/TLIF+ordinary fusion cage group, 47 cases in the Endo-TLIF+ordinary fusion cage group and 32 cases in the unilateral approach biportal endoscopic (UBE) +ordinary fusion cage group according to the operation mode. The gender, age, intraoperative bleeding, hospital stay, preoperative, immediate postoperative, 6-month postoperative and 12-month postoperative Oswestry disability index (ODI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, degree of lumbar spondylolisthesis, lumbar lordosis angle, and dural cross-sectional area were compared among the four groups. Results There was no statistically significant difference in gender, age, operative time, intraoperative bleeding, and hospital stay among the four groups of patients (P>0.05). There was no interaction effect of group and time on ODI score, VAS score, JOA score, lumbar lordosis angle, and dural cross-sectional area (P>0.05) ; there was an interaction effect of group and time on the degree of lumbar spondylolisthesis (P

Background: Despite the favorable clinical outcome of percutaneous kyphoplasty (PKP) in symptomatic osteoporotic vertebral fractures (OVFs) patients with intravertebral clefts (IVCs), previous studies have demonstrated a high incidence of augmented vertebrae recompression (AVR). We aim to evaluate the usefulness of the adjacent and injured vertebral bone quality scores (VBQS) based on T1‐weighted MRI images in AVR after PKP for OVFs with IVCs. Methods: Patients who underwent PKP for single OVFs with IVCs between January 2014 and September 2020 were reviewed and met the inclusion criteria. The follow‐up period was at least 2 years. Relevant data affecting AVR were collected. Pearson and Spearman correlation coefficients were used to calculate the correlation between the injured and adjacent VBQS and BMD T‐score. We determined independent risk factors and critical values using binary logistic regression analysis and receiver operating characteristic curves (ROC). Results: A total of 165 patients were included. Recompression group was found in 42 (25.5%) patients. The independent risk factors for AVR were lumbar BMD T‐score (OR = 2.53, p = 0.003), the adjacent VBQS (OR = 0.79, p = 0.016), the injured VBQS (OR = 1.27, p = 0.048), the ratio of adjacent to injured VBQS (OR = 0.32, p < 0.001), and cement distribution pattern. Among these independent significant risk factors, the prediction accuracy of the ratio of adjacent to injured VBQS was the highest (Cutoff = 1.41, AUC = 0.753). Additionally, adjacent and injured VBQS were negatively correlated with lumbar BMD T‐scores. Conclusion: For the patients after PKP treatment for OVFs with IVCs, the ratio of adjacent to injured VBQS had the best prediction accuracy in predicting recompression and when the ratio of adjacent to injured VBQS was <1.41, the augmented vertebrae were more likely to have recompression in the future. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the aging of the society, the number of patients with osteoporotic vertebral fracture is increasing, mainly manifesting compression fracture of thoracolumbar body, which seriously affects the daily life ofthe elderly. Therefore, to study the relationship between the degree of external force and the performance of osteoporotic thoracolumbar body fracture on MRI STIR is to provide a better basis for clinical diagnosis and treatment. OBJECTIVE: To explore the relationship between the size of external force and a linear black signal area of STIR image in MRI of thoracic and lumbar osteoporosis vertebral compression fractures. METHODS: The hospitalized patients, who were diagnosed as thoracic and lumbar osteoporosis vertebral compression fractures, were retrospectively analyzed from September 2013 to September 2016 at the Department of Spine Surgery of The First Affiliated Hospital of Guangxi University of Chinese Medicine. All cases in the three groups were diagnosed as osteoporosis by quantitative CT {bone mineral density ~ 80 mg/cm³ ). All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The patients were dMded into three groups according to the different trauma history: Non-obvious external force group (without apparent cause or external force), low energy group (sprains, bent down to lift heavy objects, and carrying heavy items), high energy group (flat road down hips touchdown, falls, and bruise). Gender, age, fracture site (thoracic lumbar segment and non-thoracic lumbar segment), the number of the vertebrae and the position where would they occur with a linear black signal area of STIR image in MRI were analyzed in each group. Age was analyzed by analysis of variance. Gender, fracture site and the number of the vertebrae and the position were analyzed by Pearson chi-square tesl RESULTS AND CONCLUSION: (1) All the 782 cases were included in the three groups. There were 334 in the non-obvious external force group, which a linear black signal area of STIR image in MRI existed in 114 cases. There were 186 cases in low energy group, which a linear black signal area of STIR image in MRI existed in 124 cases. There were 262 cases in high energy group, which a linear black signal area of STIR image in MRI existed in 87 cases. (2) The age, gender, fracture site and the number of the vertebrae and the position in three groups were not statistically significantly different among the three groups {P > 0.05). (3) There were significant differences in a linear black signal area of STIR image in MRI among the three groups (P < 0.05) (α'=0.0513=0.017). Significant differences were found as compared the low energy group with non-obvious external force group and high energy group (P < 0. 017). No significant difference was determined between non-obvious external force group and high energy group (P > 0.017). (4) The occurrence rate of linear black signal area of STIR image in MRI was 66.7% and higher than other groups (43.1% and 33.2%). (5) In the history of trauma, low energy in external force has more opportunity to cause a linear black signal area of STIR image in MRI than non-obvious external force and high energy; and they often occur in thoracic and lumbar osteoporosis vertebrae. [ABSTRACT FROM AUTHOR]