Objective: Lumbar spinal stenosis is a medical condition characterized by the narrowing of the spinal canal as a consequence of bone and soft tissue degeneration, including disc herniation, facet and ligamentum flavum hypertrophy, and osteophyte formation. The percutaneous transforaminal endoscopic discectomy (PTED) technique is one of the emerging surgical alternatives for treating central lumbar stenosis. The present study aims to describe the present techniques of PTED and foraminoplasty for central lumbar stenosis, and discuss the feasibility and advantages of this technique.Conclusion: PTED and foraminoplasty technique showed promising outcomes in the treatment of central lumbar stenosis in a 1-year follow-up period. It suggested that PTED and foraminoplasty might be applied as a safe and effective therapeutic option for patients with lumbar stenosis.

No abstract

Intervertebral disc degeneration (IDD), an important cause of chronic low back pain (LBP), is considered the pathological basis for various spinal degenerative diseases. A series of factors, including inflammatory response, oxidative stress, autophagy, abnormal mechanical stress, nutritional deficiency, and genetics, lead to reduced extracellular matrix (ECM) synthesis by intervertebral disc (IVD) cells and accelerate IDD progression. Mammalian target of rapamycin (mTOR) is an evolutionarily conserved serine/threonine kinase that plays a vital role in diverse degenerative diseases. Recent studies have shown that mTOR signalling is involved in the regulation of autophagy, oxidative stress, inflammatory responses, ECM homeostasis, cellular senescence, and apoptosis in IVD cells. Accordingly, we reviewed the mechanism of mTOR signalling in the pathogenesis of IDD to provide innovative ideas for future research and IDD treatment.

Background Percutaneous transforaminal endoscopic discectomy (PTED) and micro-endoscopic discectomy (MED) are alternative minimally invasive, widely performed procedures for the treatment of lumbar disc herniation (LDH). This study compared the clinical outcomes of these 2 surgical techniques in treating LDH. Material/Methods A comprehensive literature search was performed in PubMed, MEDLINE, EMBASE, Cochrane, and Google Scholar to identify all relevant studies comparing PTED and MED in treating LDH. Results Eight comparative studies assessing a total of 805 patients were included for the final analysis. The results indicated that PTED needs a shorter incision [−1.02 (−1.21 to −0.83), p<0.001], less time in bed [−2.14 (−3.34 to −0.94), p<0.001], and shorter hospital stay [−1.92 (−2.90 to −0.94), p<0.001], whereas MED is superior regarding intraoperative fluoroscopy [7.47 (2.78 to 12.17), p=0.002] and total cost [0.69 (0.38 to 1.00), p<0.001]. No significant differences were found on operation time, intraoperative blood loss, or complications. Significant lower back pain was found in the PTED group at 1 week postoperatively [−0.52 (−0.95 to −0.10), p=0.02] and 1 year postoperatively or the last follow-up [−0.41 (−0.76 to −0.06), p=0.02]; significant lower leg pain was also detected at 1 week postoperatively [−0.52 (−0.75 to −0.30), p<0.001]. Oswestry Disability Index (ODI) was significant better at 1 week postoperatively in the PTED group [−4.41 (−7.03 to −1.79), p=0.001]. No significant differences were detected at other time points regarding pain score and ODI. Conclusions Both PTED and MED are safe and effective techniques for treating LDH. However, taking all clinical outcomes together, PTED might be a preferable treatment modality for LDH.

Gastric carcinosarcoma is a rare, malignant neoplasm that simultaneously comprises mixed epithelial and mesenchymal elements. In the present study, we report a case of gastric carcinosarcoma composed of rhabdomyosarcoma and adenocarcinoma on F-FDG PET/CT.

The two-stage posterior-only procedures permitting stepwise correction for the treatment of severe spinal deformities provide safe and satisfactory outcomes in this patient population.

Recently, female breast cancer (BC) has surpassed lung cancer to occupy the first place of the most commonly diagnosed cancer. The unsatisfactory prognosis of endocrine therapy for breast cancer might be attributed to the discordance in estrogen receptor (ER) status between primary tumors and corresponding metastases, as well as temporal and spatial receptor status heterogeneity at point-in-time between biopsy and treatment. The purpose of this study was to evaluate the prognostic and predictive value of ER status in circulating tumor cells (CTCs) in BC patients. We analyzed ER expression on CTCs isolated using the Pep@MNPs method in 2.0 ml of blood samples from 70 patients with BC and 67 female controls. The predictive and prognostic value of ER expression in CTCs and immunohistochemistry results of biopsies for progression-free survival (PFS) and overall survival (OS) of patients in response to therapies were assessed. The detection rate for CTCs was 95.71% (67/70 patients), with a median of 8 CTCs within 2 ml of peripheral venous blood (PVB). A concordance of 76.56% in ER status between CTCs and corresponding primary tumor and 69.23% between CTCs and corresponding metastases was observed. We also found that patients with ER-positive CTCs (CTC ER+) had longer PFS and OS than those without ER-positive CTCs (CTC ER-). Our findings suggested that ER status in CTCs of BC patients may provide valuable predictive and prognostic insights into endocrine therapies, although further evaluation in larger prospective trials is required.

Study Design：Retrospective case–control radiographic study Purpose The purpose of this study is to compare hilus pulmonis (HP) method and full balance integrated (FBI) method in calculating the amount of correction angle needed to achieve a satisfactory sagittal balance for ankylosing spondylitis (AS) patients with thoracolumbar kyphosis, then, to explore if HP method can be safely used instead when C7 vertebra is invisible. Methods 38 AS patients (34 men, 4 women; mean age, 38.4 yr) who underwent one-level PSO for thoracolumbar kyphosis deformity were retrospectively collected. The planned osteotomy angles were calculated on preoperative full-length spinal radiographs using both methods (HP and FBI). Pre- and post-operative sagittal parameters were also assessed, including Cobb T1- S1, global tilt, sagittal vertical axis (SVA), pelvic tilt, lumbar lordosis, femoral obliquity angle (FOA). Results All radiographical parameters had significantly improved from preoperative to postoperative. The T1–S1 sagittal Cobb angles significantly improved from 43.5 ° (range, -12.1° ~84.5°) preoperatively to 9.2° (range, −15.7°~33.7°) postoperatively (P < 0.001). All radiographical parameters had significantly improved from preoperative to postoperative, including global tilt (52.3°~21.8°, P<0.001), SVA (139.4 ~ 58.1mm, P < 0.001), PT (33.6° ~16.8°, P<0.001), lumbar lordosis (1.9°~-36.3°, P<0.001) and femoral tilt (22.0° ~10.1°, P<0.001). The mean osteotomy angle was 28.2° (range 20.4°~41.9°). The average predicted correction angles with FBI method and HP method were 43.70° and 51.80°, respectively. There was significant difference between these two methods in terms of predicted correction angle (P=0.001). Conclusions In AS patients with only thoracolumbar kyphosis, HP method had greater estimated correction angle than FBI method. Since our experience confirmed that all patients achieved the best equilibrium when C7 plumb line closed to the sacral plateau according to FBI method, HP method could not be safely used instead to calculate the estimated correction angle.