Objective To assess the clinical efficacy of three different surgical approaches in the treatment of thoracolumbar tuberculosis. Methods A total of 138 patients with thoracolumbar tuberculosis treated by open surgery were retrospectively analyzed. The surgical methods were divided into anterior, posterior and anterior–posterior combined. The hospital stays, amount of bleeding, operative time, preoperative, postoperative and last follow-up ESR, CRP, Frankel score, ODI, VAS, correction and loss rate of kyphosis, fusion rate and complications were recorded and analyzed. Results The average follow-up was 66 months. The average hospital stay, operative time and amount of bleeding of the anterior–posterior combined group were higher than other groups (P < 0.05). ESR and CRP of all patients were reduced postoperatively (P < 0.05). No significant difference among the three groups was found in the postoperative correction angle of kyphosis (P < 0.05), while the pre- and postoperative Cobb angle as well as correction rate had significant differences. The posterior approach could achieve better correction, and the loss of correction was more in the anterior group, 40.9 percent of patients performed correction loss. The Frankel score, VAS and ODI were significantly reduced among the three groups, and the incidence rate of complications of the anterior approach was lower than the other groups, with a significant difference (P < 0.05). Conclusion The anterior approach has more advantages and fewer complications, which is supposed to give preference to and could not be replaced by the posterior and anterior–posterior combined approach.

This study aimed to discuss the effects of one stage surgical treatment by simultaneous osteotomy and asymmetric lengthening by Ilizarov external fixator on short femur with severe deformity of genu valgus. A total of 12 cases with unilateral deformities treated by simultaneous osteotomy and Ilizarov asymmetric lengthening on short femur with severe deformity of genu valgus were retrospectively analyzed from January 2006 to April 2015. The affected limbs were 2.5–11 cm (5.2 cm on average) short, the femorotibial angle was 135°–158° (146.3° on average), and the ankle interval was 15–43 cm (24.7 cm on average). The Paley method was used to determine the osteotomy plane (distal femur) of genu valgus. According to this standard, the bone union results were as follows: 11 had excellent and 1 had good, where 7 patients had excellent and 5 had good functional outcomes. One stage surgical treatment by simultaneous osteotomy and asymmetric lengthening on short femur with severe deformity of genu valgus was considered to be an effective and reliable method with better osteotomy union, less trauma and fewer complications.

The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.