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Jian Lu,1,* Changjun Sun,2,* Jiangbo Bai,1,* Siyu Tian,1,* Bing Zhang,1 Dehu Tian,1 Lingde Kong1 1Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China; 2Department of Emergency, The Second Hospital of Tangshan City, Tangshan, Hebei 063000, China *These authors contributed equally to this work Background: This study was conducted to determine whether sagittal lordotic alignment and clinical outcomes could be improved by the correction of segmental kyphosis after single-level anterior cervical discectomy and fusion (ACDF) surgery.Patients and methods: We retrospectively reviewed patients who underwent single-level ACDF surgery in our hospital between January 2014 and February 2017. Basic characteristics of patients included age at surgery, gender, diagnosis, duration of symptoms, and location of target level. Pre- and postoperative radiographs at the 6-month follow-up were used to evaluate the following parameters, such as segmental angle, C2–C7 angle, T1 slope, and C2–C7 sagittal vertical axis (SVA). Postoperative clinical outcomes were assessed by the Neck Disability Index and VAS. According to the segmental angle of postoperative radiographs, patients were divided into noncorrection group and correction group.Results: A total of 181 patients (99 males and 82 females) were analyzed in our study. There were 32 patients in the noncorrection group and 149 patients in the correction group. There was no significant difference in demographic and clinical data between the two groups before surgery. However, patients in the correction group showed larger C2–C7 angle and lower C2–C7 SVA after surgery in comparison with those in the noncorrection group. Besides, changes in the segmental angle were positively correlated with changes in C2–C7 angle and negatively correlated with changes in C2–C7 SVA.Conclusion: Surgical correction of segmental kyphosis in

Lingde Kong,* Jiangbo Bai,* Kunlun Yu, Bing Zhang, Jichun Zhang, Dehu Tian Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China *These authors contributed equally to this work Background: In the treatment of cubital tunnel syndrome (CuTS), in situ ulnar nerve decompression is commonly used. This study aims to investigate predictive factors for poor recovery and ulnar nerve instability following this procedure. Methods: We enrolled 235 patients who underwent in situ ulnar nerve decompression for the treatment of CuTS from January 2010 to December 2014. All patients underwent >2 years’ follow-up. The primary outcome was postoperative recovery, which was assessed by Messina’s criteria, and the secondary outcome was postoperative ulnar nerve instability. Potential risk factors were collected from demographic data and electrodiagnostic test, which included age, gender, body mass index, history of tobacco or alcohol use, history of major medical comorbidities, disease duration, preoperative severity, motor conduction velocity, and sensory conduction velocity. Results: A total of 208 patients (88.5%) had satisfactory outcomes, while the other 27 patients (11.5%) had not. There were 25 patients (10.6%) showing postoperative ulnar nerve instability during follow-up. The multivariate analysis showed that only severe preoperative symptom (odds ratio [OR], 3.06; 95% confidence interval [CI], 2.16–4.32) was associated with unsatisfactory postoperative outcomes in patients with CuTS (P<0.001). In the model investigating independent factors associated with postoperative ulnar nerve instability, we found that young age (OR, 2.41; 95% CI, 1.63–3.58) was associated with the incidence of postoperative ulnar nerve instability (P<0.001). Conclusion: We found that severe preoperative symptom was associated with unsatisfactory postoperative outcomes, and y

Hongfang Zhao,* Siyu Tian,* Lingde Kong,* Jiangbo Bai,* Jian Lu, Bing Zhang, Dehu Tian Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to investigate the union time of acute middle-third scaphoid fractures following treatments and to analyze the effect of different factors on late union.Patients and methods: We retrospectively reviewed patients with acute middle-third scaphoid fracture at our institution between January 2013 and December 2017. Patient demographics, fracture characteristics, and treatment strategy, such as age, gender, body mass index, habit of smoking, sides of injury, dominant hand, ulnar variance, multiple fractures, and treatment methods, were investigated. Univariate and multivariate analyses were used to identify possible predictive factors.Results: A total of 132 patients with scaphoid fracture were included in our study. Operation was performed in 67 patients (50.8%), and conservative treatment was performed in the other 65 patients (49.2%). The union time was 7.2±0.5 weeks. In the multivariate logistic regression analysis, late diagnosis (odds ratio, 1.247; 95% CI, 1.022–1.521) and conservative treatment method (odds ratio, 1.615; 95% CI, 1.031–2.528) were identified as 2 independent predictors of late union in scaphoid fractures patients. Other parameters were not demonstrated to be predictive factors.Conclusion: Late diagnosis and conservative treatment were two factors associated with late union. Long time of follow-up is necessary for patient with these factors. Keywords: predictive factors, union time, nonunion, scaphoid fractures, multivariable analysis

Jiangbo Bai,* Kunlun Yu,* Yaning Sun, Lingde Kong, Yong Shen Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to assess the prevalence of cervical Modic change (MC) in patients with cervical spondylosis and to develop a better understanding of the possible risk factors for the prevalence of MC.Methods: Between January 2014 and April 2017, patients with cervical spondylosis were included in our study. All patients underwent magnetic resonance imaging (MRI) to evaluate the presence of MC. The MC was classified into three types according to the Modic classification. Potential risk factors were collected from demographic data, lifestyle variables, laboratory tests, and radiographic images. Both univariate and multivariate analysis were used to detect factors associated with MC. We further compared several variables related to fat metabolism between patients with Type 1 and Type 2 MC.Results: The prevalence of MC in patients with cervical spondylosis was 9.24%. The MC was most frequent at C5–6, followed by C6–7, C4–5, and C3–4. The proportion of Type 1 MC in patients with neck pain was significantly higher than that in patients without neck pain (46.2% vs 13.6%, P=0.027). However, none of the variables associated with fat metabolism showed a significant difference between Type 1 and Type 2 MC. Multivariate logistic analysis showed that age ≥55 years (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.22–2.98) and body mass index (BMI) ≥25 kg/m2 (OR, 2.41; 95% CI, 1.62–3.59) were two significant independent factors that are associated with cervical MC in patients with cervical spondylosis (P<0.05).Conclusion: It appears that advanced age and high BMI were two factors that may be responsible for cervical MC. Type 1 MC is a

Lingde Kong,* Jiangbo Bai,* Bing Zhang, Yong Shen, Dehu Tian Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to determine the incidence of coexisting symptomatic lumbar canal stenosis (LCS) in patients after surgery for cervical spondylotic myelopathy (CSM) and identify possible predictive factors associated with it.Materials and methods: We retrospectively reviewed patients with CSM at our institution between January 2005 and December 2015. Clinical and radiographic factors including age, gender, body mass index, Japanese Orthopedic Association scores, cervical alignment, anteroposterior diameter of cervical canal, number of levels with CSM, and percentage of cervical cord compression were investigated. Symptomatic LCS was defined as leg symptoms and a narrowing of the lumbar spinal canal at one level at least, which is confirmed by magnetic resonance images of the lumbar spine. Univariate and multivariate analyses were used to identify possible predictive factors. Pearson correlation analysis was also conducted to analyze the association between cervical parameters and percentage of LCS.Results: A total of 317 patients with CSM met the criteria for inclusion. There were 39 patients (12.3%) with LCS after cervical surgery during a mean of 7.3 years’ follow-up. In the multivariate logistic regression analysis, narrow diameter of cervical canal (OR, 3.96; 95% CI, 1.20–13.04) was identified as the only independent predictor of symptomatic LCS in CSM patients. The correlation coefficient between anteroposterior diameter of cervical canal and severity of LCS indicated a significantly positive linear relationship with 0.536 (P<0.001).Conclusion: We found that narrow diameter of cervical canal was associated with symptomatic LCS in CSM patients. Patients with this risk factor s