Aim: To compare the clinical and radiographic outcomes of percutaneous endoscopic-assisted lumbar interbody fusion (PELIF) versus oblique lumbar interbody fusion (OLIF) for the treatment of symptomatic low-grade lumbar spondylolisthesis. Material & methods: The clinical and radiographic records of 48 patients underwent single-level minimally invasive lumbar fusion with a PELIF (n = 16) or OLIF (n = 32) were reviewed. Results: The clinical and radiographic outcomes were similar in both groups. PELIF procedure exhibited superior capability of the enlargement of foraminal width, but inferior capability of the restoration of foraminal height than OLIF procedure. Conclusion: PELIF minimizes the iatrogenic damages and perioperative risks to a great extent, and seems to be a promising option for the treatment of symptomatic low-grade lumbar spondylolisthesis.
Rationale:
Intraspinal tophaceous gout is relatively rare condition presenting with major clinical manifestations, such as spinal cord or nerve roots compressions (radiculopathy). It is usually difficult to differentiate intraspinal tophaceous gout, lumbar disc herniation, stenosis of spinal canal, ossification of ligamentum flavum, and other degenerative spinal disorders from each other.
Patient concerns:
A 64-year-old man was admitted with a history of progressive low back pain for 11 months. He also presented with radiculopathy and numbness of his left lower extremity.
Diagnoses:
Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) showed L4/5 disc herniation and lateral recess stenosis on the left side. During the operation of percutaneous transforaminal endoscopic decompression, intraspinal chalky white material was seen. Post-operative pathologic results confirmed the diagnosis of gouty tophi.
Interventions:
Percutaneous transforaminal endoscopic decompression was performed as treatment. Intraspinal chalky white material was seen. We removed most of the chalky white material and extruded nucleus.
Outcomes:
His symptom subsided rapidly and no deterioration was noted 1 year post-operatively.
Lessons:
Although intraspinal tophaceous gout is not commonly seen, clinicians should take it into consideration as a possible differential diagnosis when the patient exhibits axial pain or neurological deficits with risk factors of gout. We identified and treated this case with percutaneous transforaminal endoscopic decompression for the first time and got an excellent outcome. Percutaneous transforaminal endoscopic surgery proved to be an effective and minimally invasive alternative for identifying and treating intraspinal tophaceous gout.
The relationship between maximal muscle strength (MMS) and bone mineral density (BMD) in males remains unclear. Therefore, the aim of this cross-sectional study was to investigate the association of MMS, using 3 fundamental compound exercises, and body composition with BMD in Chinese male adults. One hundred forty-seven Chinese male adults aged 20 to 47 years were recruited. Total and regional BMD and body composition were measured using dual-energy X-ray absorptiometry. Measurements of MMS included bench press, deadlift, and squat 1-repetition maximum (1RM). Bench press, deadlift, squat 1RM, fat mass (FM), and lean mass (LM) had a significant positive association with BMD. Intriguingly, squat 1RM was found to have a stronger association than bench press or deadlift 1RM, whereas bench press 1RM was found as the strongest determinant of BMD at the forearm sites. Furthermore, LM was found to be stronger related with BMD than FM. Our findings identify LM, FM and MMS are positively associated with BMD and squat may serve as a simple, most efficient strategy to optimize peak total body BMD, while bench press fit best for forearm BMD. Our results validate the benefits of MMS training in males and underscores site-specific effects on BMD levels. These findings emphasize the need for prospective studies to investigate the maximum therapeutic potential and sex specific modifiers of MMS training.
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