［Abstract］　Objective　To observe the short and medium-term clinical efficacy of anterior cervical hybrid surgery in treatment of two- or multi-level cervical spondylosis. Methods　The clinical data of 13 patients with cervical spondylosis who were treated with the hybrid surgery in our hospital from January 2017 to December 2021 were retrospectively analyzed. The Visual Analogue Scale(VAS) score and Japanese Orthopaedic Association(JOA) score were used to evaluate the clinical efficacy. The cervical X-ray and three-dimensional reconstruction of computed tomography(CT) scan were used to evaluate the imaging indexes such as the segmental range of motion(ROM) of replacement, the global ROM of cervical spine, the position of cervical disc prosthesis, the fusion rate of internal fixation, and heterotopic ossification. Results　All the 13 patients were followed up for 8 to 45 months, with an average of 14.6 months. There was no statisticall significant difference between postoperative replacement gap mobility (9.12±1.86)° and preoperative replacement gap mobility (9.21±1.76)°(P>0.05), while for overall cervical mobility, there was a significant decrease in postoperative mobility (39.67±5.57)° compared with preoperative mobility (52.12±6.43)°(P<0.05). The mean VAS scores were (1.37±0.78)points one month after operation, which were significantly improved compared with those before operation［(4.85±1.25)points］(P<0.05). The mean JOA scores were (15.32±1.92)points three months after operation, which were significantly improved compared with those before operation［(11.36±2.11)points］(P<0.05). The fixed segments of all the patients were fused 6 months after operation, and the position of the artificial disc was good, with no implant loosening, subsidence, and no heterotopic ossification occurred. Proximal adjacent segment degeneration occurred in 1 case after operation. Conclusion　The hybrid procedure of anterior cervical artificial disc replacement combined with fusion internal fixation for two- or multi-level cervical spondylosis can significantly relieve the patients′ clinical symptoms, reduce the number of fused segments and preserve cervical mobility.This operation procedure has good clinical efficacy and certain technical advantages.]]> 2023/3/30 12:08:58 WU Jia-chang, FANG Guo-fang, LAI Guo-hua, et al. 5true ［Abstract］　Objective　To analyse the effect of oblique lateral interbody fusion(OLIF) combined with anterolateral screw fixation on treatment of degenerative lumbar spondylolisthesis(DLS). Methods　A retrospective analysis was performed on 76 patients who underwent OLIF combined with anterolateral screw fixation for DLS at the L_4-5 levels in West China Hospital, Sichuan University between January 2018 and August 2021. The operation time, intraoperative blood loss, hospital stay and postoperative complications were recorded. The Visual Analogue Scale(VAS) score and Oswestry Disability Index(ODI) score for assessing the low back and legs were compared among the follow-up patients before operation, 3 months and 12 months after operation. The radiographic parameters including lumbar lordosis(LL) and segmental lordosis(SL), and disc height(DH), slip distance(SD) and cage subsidence in the computed tomography(CT) sagittal reconstruction image were measured before operation, and at the follow-up time of 1 day, 3 months and 12 months after operation. The slip correction rate was calculated, and the fusion condition and fusion rate were evaluated. Results　The mean operation time was (99.2±13.1)minutes, and the intraoperative blood loss was (37.8±7.1)ml. All the patients were followed up for more than 1 year. The VAS scores for lumbago, the VAS scores for leg pain and the ODI scores in the patients were significantly improved 3 months and 12 months after operation compared with those before operation, and the differences were statistically significant(P<0.05). The LL, SL, DH and SD were significantly improved 1 day, 3 months and 12 months after operation compared with those before operation, and the differences were statistically significant(P<0.05). The DH was decreased 3 months and 12 months after operation compared with that 1 day after operation, and the difference was statistically significant(P<0.05). Intraoperative endplate injury at L₅ vertebra was observed in 2 patients. A total of 17 patients developed cage subsidence, and other 2 patients suffered from numbness in the front of the thigh. A total of 70 patients achieved interbody bone grafting fusion 12 months after operation, with a fusion rate of 92.11%. Conclusion　OLIF combined with anterolateral screw fixation has a satisfactory clinical effect on the treatment of DLS, which can effectively correct lumbar lordosis and segmental lordosis. The partial reduction of spondylolisthesis and spinal canal decompression are effective. It is a safe, effective and minimally invasive technique for treating degenerative lumbar spondylolisthesis.]]> 2023/3/30 12:08:58 LI Zhu-hai, ZENG Jian-cheng, WANG Xian-di, et al. 4true ［Abstract］　Objective　To explore the sagittal spinal balance and its gender-dependent differences in an asymptomatic 75-year-old Chinese population, and to provide reference for the diagnosis and treatment of the 75-year-old patients with sagittal spinal imbalance. Methods　The clinical data of 100 cases of 75-year-old patients without low back pain but with neck and shoulder pain who were admitted to the Outpatient Department of Xuanwu Hospital, Capital Medical University from January 2018 to January 2020 were retrospectively analyzed. Among the 100 patients, 50 cases were male and the other 50 cases were female. All the patients were examined using the full-length spinal radiographs. Lumbar lordosis(LL), sacral slope(SS), pelvic tilt(PT), pelvic incidence(PI), thoracolumbar angle(TLK), thoracic kyphosis(TK), sagittal vertical axis(SVA) of C₇-S₁, and T₁ pelvic angle(TPA) were measured in the patients.The sagittal spinal morphology was also classified according to the Roussouly classification system. Results　The PI, PT, TPA and PI-LL(PI minus LL) in the male patients were significantly lower than those in the female patients(P<0.05). However, there were no significant gender-dependent differences in TK, TLK, LL, SS and SVA(P>0.05). From Roussouly Ⅰ to Roussouly Ⅳ, the sagittal spinal morphology in the male patients accounted for 54.0%, 20.0%, 18.0% and 8.0%, respectively, while that in the female patients accounted for 36.0%, 26.0%, 28.0% and 10.0%, respectively. There were no significant differences in the classification distributions between the two groups(P>0.05), and type Ⅰ accounted for the highest proportion, and type Ⅳ was the least. Conclusion　The sagittal spinal morphology of the asymptomatic 75-year-old Chinese population maintains a certain shape, and there exists a gender-dependent difference. There is no significant difference in the Roussouly classification distribution trend of the spine between male and female populations. The results can provide reference for the treatment of 75-year-old patients with sagittal imbalance.]]> 2023/3/30 12:08:59 PAN Fu-min, KONG Chao, HAN Di, et al. 3true ［Abstract］　Lumbar and back pain caused by intervertebral disc degeneration(IDD) is one of the diseases with high disability rate, and its incidence is often chronic, progressive and irreversible. Therefore, how to delay or reverse IDD has become a new research focus, such as gene therapy, stem cell therapy and cytokine therapy. Now, with the discovery of transcription factors in the development of intervertebral discs, it is possible to develop a novel therapy for intervertebral discs. Therefore, the role of transcription factors in the development of intervertebral discs is reviewed in this paper.]]> 2023/3/30 12:08:59 LI Hao-xi, WEI Jian-xun 2true ［Abstract］　Objective　To explore the effect of the relationship between pedicle screw and upper endplate on adjacent segment after posterolateral lumbar fusion(PLF). Methods　From September 2015 to June 2022, a total of 189 patients who underwent PLF at L₄-S₁ with or without L₅ bone cement screw in our department and with a follow-up period of at least 2 years were selected, including 53 patients in the adjacent segment degeneration(ASD) group and 136 patients in the non-ASD group. Multivariate binary logistic analysis was performed to identify the independent risk factors of ASD. Receiver operating characteristic(ROC) curve was performed to analyze the predictive efficacy of the study indicators on ASD. Results　Compared with the non-ASD group, the ASD group exhibited a larger sagittal screw angle between the pedicle screw and the upper endplate of the vertebral body, and a shorter distance from the screw apex to the upper endplate(P<0.05). The results of multivariate binary logistic analysis indicated that the distance from the screw apex to the upper endplate［OR(95%CI): 0.150(0.067-0.336)］, the sagittal screw angle between the pedicle screw and the upper endplate of the vertebral body［OR(95%CI): 2.404(1.608-3.594)］ were the factors influencing the occurrence of ASD(P<0.05), and the results of ROC curve analysis showed that they all had the application value in predicting ASD(P<0.05), with the optimum cut-off value being 6.25 mm and 5.50°, respectively. Conclusion　The sagittal screw angle between the pedicle screw and the upper endplate of the vertebral body, and a distance from the screw apex to the upper endplate are significantly associated with the risk of ASD.]]> 2023/3/30 12:08:59 WANG Qiang, WU De-sheng 1true