Search

Background: Calcified lumbar disc herniation (CLDH) is considered to be a special type of lumbar disc herniation (LDH). Percutaneous endoscopic interlaminar discectomy (PEID), with safety and efficacy, has been proved to be a minimally invasive surgery for LDH. However, there are few studies on PEID in the treatment of CLDH at L5-S1 level. This research aimed to analyze the clinical efficacy of PEID for L5-S1 CLDH.Methods: From August 2016 to April 2020, we retrospectively analyzed 28 consecutive patients (17 males; 11 females) with L5-S1 CLDH treated with PEID at our institution. All the patients were followed up for greater than 1 year postoperatively. The demographic characteristics, surgical results and clinical outcomes estimated by the visual analog scale (VAS) for leg pain, Oswestry disability index (ODI) and modified MacNab criteria were collected.Results: All patients were successfully performed by PEID. The mean operative time and intraoperative blood loss were 65.36 ± 5.26 minutes and 13.21 ± 4.35 ml, respectively. The VAS for leg pain and ODI scores improved remarkably from 7.54 ± 0.96 to 1.50 ± 0.51 (P < 0.05) and from 69.29 ± 9.91 to 17.43 ± 3.69 (P < 0.05) a year after operation, respectively. According to the modified MacNab criteria of the last follow-up, the excellent and good rates are 92.86%. Two of the patients had complications, one had nerve root injury and the other had postoperative dysesthesia.Conclusions: PEID achieved good clinical outcomes in the treatment of L5-S1 CLDH. And PEID was a safe and effective minimally invasive surgery for L5-S1 CLDH.

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively safe and effective minimally invasive surgery in the treatment of calcified lumbar disc herniation (CLDH). However, studies on percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) for CLDH have rarely been reported. This research aimed to compare the clinical efficacy of PEID and PETD for L5-S1 CLDH.Methods: We retrospectively analyzed 42 consecutive patients with L5-S1 CLDH treated with PELD at our institution from August 2016 to December 2019. Patients were divided into PEID group (n = 24) and PETD (n = 18) group according to the surgical methods. The demographic characteristics and surgical results of the two groups were compared. Clinical outcomes were estimated by the visual analog scale (VAS) for leg pain, Oswestry disability index (ODI) and modified MacNab criteria.Results: All patients were successfully operated on by PEID or PETD. No significant differences in the demographic characteristics, intraoperative blood loss, postoperative hospital stay and complication rate were noted between the PEID and PETD groups (P > 0.05). The excellent and good rates in the PEID group were similar to those in the PETD group (91.67% vs 88.89%, P > 0.05), whereas the PEID group exhibited superior results for operative time (m) (64.58 ± 5.88 vs 85.56 ± 9.06, P < 0.05) and fluoroscopy times (n) (2.96 ± 0.96 vs 13.33 ± 2.64, P < 0.05) compared with the PETD group.Conclusions: PEID had achieved good clinical efficacy as PETD for L5-S1 CLDH. Compared with PETD, PEID had the advantages of shorter operative time and a reduced number of fluoroscopy times in the treatment of CLDH.

Background Modular prosthesis fracture, especially distal femoral fracture, is a rare complication of total hip arthroplasty (THA). However, it is catastrophic, and may have a serious impact on the patients. A distal femoral prosthesis fracture in a patient with developmental dysplasia of the hip (DDH) with nonunion at the subtrochanteric osteotomy site has not yet been reported in any literature. This report presents the first such case, with a purpose of analyzing the causes of modular prosthesis fractures and nonunion of the osteotomy area, so as to provide orthopedic surgeons with experience and lessons. Case presentation We report the case of a 52-year-old woman with the distal femoral prosthesis fracture after THA and subtrochanteric osteotomy for Crowe type IV DDH. The patient had severe pain in the left thigh and her activities were limited. Plain radiographs revealed fracture of the left distal femoral prosthesis and nonunion in the subtrochanteric osteotomy region of the left femur. After a revision of the THA, the patient’s symptoms were resolved. Conclusions A prosthesis fracture combined with nonunion at the subtrochanteric osteotomy site is a rare complication. Modular THA combined with a subtrochanteric osteotomy in the treatment of Crowe type IV DDH should reduce the damage to blood supply and avoid further nonunion of the osteotomy area, which may otherwise lead to modular prosthesis fractures. A detailed preoperative plan and suitable rehabilitation program may help minimize the occurrence of subtrochanteric osteotomy nonunion and reduce complications, including femoral prosthesis fractures, in patients with DDH.

Background Osteosarcoma is a primary malignant bone tumor that occurs in children and adolescents. Increasing numbers of scholars have studied its development and treatment. To fully understand the current status of osteosarcoma research and global trends therein, we performed a bibliometric and visual analysis of osteosarcoma studies published between 1999 and 2019. Methods We searched the Web of Science database for publications on osteosarcoma. The basic characteristics of this sample of publications, such as H indices, annual outputs, languages of publication, and authors, journals, institutions, and countries of origin, were determined. Co-citation, collaboration, and keyword co-occurrence were analyzed using CiteSpace software. Results The sample comprised 16,934 articles. The number of publications increased annually. H indices and total numbers of citations were far higher for articles from the United States than for those from other countries. Among institutions, the largest proportion of articles originated from Shanghai Jiaotong University. R. Gorlick was the author with the highest H index and total number of citations. Oncology Letters published the largest number of articles and Cancer Research was the most frequently cited journal. The five most frequently appearing keywords were “osteosarcoma,” “cancer,” “expression,” “apoptosis,” and “metastasis.” The analysis generated 10 major clusters of keywords and 23 clusters of co-cited references. Conclusions The findings of this study have guiding significance for researchers seeking cooperating institutions and partners for osteosarcoma research, popular journals and important literature in the field, an understanding of the knowledge base for this research, and up-to-date identification of research hotspots and trends. Keywords: osteosarcoma, bibliometric, citespace, visual analysis, co-citation

Objectives Percutaneous transforaminal endoscopic decompression (PTED) under local anesthesia is rarely performed for lumbar spinal stenosis (LSS) with degenerative lumbar spondylolisthesis (DLS) because of the limited field of vision, inherent instability, etc. The objective of this study was to describe the procedure of the PTED technique and to demonstrate the early clinical outcomes. Patients and methods From January 2017 to January 2019, 40 consecutive patients aged 60 and older were diagnosed with LSS with DLS in our institution and underwent PTED. All patient were followed up to 1 year postoperatively. The clinical outcomes were evaluated using the visual analogue scale (VAS), Oswestry Disability Index (ODI) and modified MacNab criteria. Results The mean age was 70.2 ± 7.1 years. Follow-up ranged from 12 to 24 months. The mean ± SD values of the preoperative VAS leg pain and ODI scores were 7.5 ± 1.1 and 67.3 ± 9.3, respectively. The scores improved to 2.2 ± 1.1 and 20.7 ± 8.1 at 12 months postoperatively. The outcomes of the modified MacNab criteria showed that 87.5 % of patients obtained a good-to-excellent rate. The percent slippage of spondylolisthesis before surgery (10.8 ± 2.6 %) and at the end of follow-up (11.0 ± 2.4 %) was not significantly different. One patient had a dural tear and intracranial hypertension, and one patient had tibialis anterior weakness. Conclusion PTED under local anesthesia could be an effective treatment method for LSS with DLS in elderly patients. However, potential complications still require further evaluation.