Frontiers in Surgery最新文献

{"title":"Fluorescence intensity of parathyroid glands in thyroid and parathyroid surgery: a near-infrared autofluorescence study.","authors":"Fan Yu, Xiaolei Yi, Zihan Lin, Yinyue Wu, Quanyong Luo, Bo Wu","doi":"10.3389/fsurg.2025.1559274","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1559274","url":null,"abstract":"<p><strong>Objective: </strong>Near-infrared autofluorescence (NIRAF) imaging shows promise in identifying parathyroid gland (PG) during surgery. However, the clinical application of NIRAF faces challenges due to the heterogeneous fluorescence intensity (FI) of PGs observed in different thyroid and parathyroid diseases. This study aimed to evaluate the effectiveness of NIRAF in PG detection and to analyze the FI of PGs in patients with various thyroid and parathyroid diseases.</p><p><strong>Methods: </strong>A total of 105 patients undergoing thyroidectomy and parathyroidectomy were enrolled. Intraoperative NIRAF imaging was used to detect PGs, and the FI values were quantified using ImageJ software. Normal PGs were grouped according to the pathological results of ipsilateral thyroid diseases. Compare and analyze the FI values of normal and diseased PGs.</p><p><strong>Results: </strong>A total of 239 PGs were detected during surgery. 225 PGs were identified by NIRAF. The NIRAF identification rate was significantly higher than visual identification (94.1% vs. 81.2%, <i>p</i> < 0.001). NIRAF demonstrated high performance in PG identification, with sensitivity, specificity, and positive predictive values and negative predictive values to predict PGs were 95.4%, 77.5%, 90.5% and 88.1%, respectively. The FI of PGs was higher in patients with papillary thyroid carcinoma (1.39 ± 0.21), follicular nodules of thyroid (1.45 ± 0.25), nodular thyroid gland (1.36 ± 0.19) than in those with hyperthyroidism (1.06 ± 0.28) and primary hyperparathyroidism (1.17 ± 0.23). Superior PGs in Stage I exhibited higher FI compared to PGs in Stage II (<i>p</i> = 0.025). In Stage II, the FI of inferior PGs was significantly higher than that of superior PGs (<i>p</i> < 0.001). The FI of PGs in both Stage I and II was significantly higher than in Stage III.</p><p><strong>Conclusions: </strong>NIRAF demonstrates high efficiency in identifying PGs across various surgical stages, outperforming conventional visual identification. The FI of superior and inferior PGs exhibits significant variability across different intraoperative stages. Surgeons should exercise caution when identifying PGs in patients with primary hyperparathyroidism and hyperthyroidism, as these conditions are associated with lower FI compared to other thyroid diseases.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1559274"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isthmic spondylolisthesis combined with schwannoma occurring at the same vertebral level: a case report and literature review.","authors":"Renrui Niu, Jianhui Zhao, Chaoyuan Li, Fengshuo Guo, Yuchi Duan, Wenqi Luo, Rui Gu","doi":"10.3389/fsurg.2025.1457408","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1457408","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of schwannomas at the level of isthmic spondylolisthesis has not yet been reported. Preoperative identification of the responsible lesion and a rational surgical plan are essential for successful surgery.</p><p><strong>Case presentation: </strong>We report the case of a 56-year-old woman who presented with a six-year history of low back pain and a three-year history of radiating pain in the left lower extremity. Physical examination revealed signs of left L5 root compression. Computed tomography revealed left L5-S1 intervertebral foramen stenosis with an isthmic fracture. Unexpectedly, magnetic resonance imaging (MRI) showed an abnormal 12 mm*11 mm*21 mm intradural mass with inhomogeneous contrast enhancement at the level of the spondylolisthesis. Isthmic spondylolisthesis and schwannoma were suspected. Based on the imaging and physical findings, we inferred that the lower-extremity pain was primarily caused by lumbar spondylolisthesis. Under general anesthesia, the patient underwent posterior lumbar interbody fusion of L5-S1 and intradural total tumorectomy. Histopathological examination of the surgical specimen revealed a schwannoma. The patient's symptoms resolved postoperatively, and intervertebral fusion was satisfactory at the 12-month follow-up.</p><p><strong>Conclusion: </strong>This case demonstrates the difficulty of determining the responsible lesion, highlighting the importance of meticulous clinical and imaging examinations. Determining the responsible lesion is crucial for diagnosis and treatment.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1457408"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral parasternal and rectus sheath blocks reduce pain post-cardiac surgery: a pilot trial.","authors":"Yangsi Huang, Chengdi Ouyang, Fang He, Yu Zhong, Guofeng Liu, Yizhi Lu, Yanhua Chen","doi":"10.3389/fsurg.2025.1526890","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1526890","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.</p><p><strong>Methods: </strong>Eighty patients were randomly assigned to either the intervention group (receiving PSB + RSB, <i>n</i> = 40) or the control group (not receiving PSB + RSB, <i>n</i> = 40). The primary outcome was opioid consumption within the first 24 h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.</p><p><strong>Results: </strong>The intervention group showed significantly reduced opioid consumption in the first 24 h postoperatively compared to the control group (<i>P</i> < 0.05), though no significant difference was observed at 48 h postoperatively. VAS pain scores at extubation and at 12, 24, and 48 h post-extubation were significantly lower in the intervention group (<i>P</i> < 0.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group (<i>P</i> < 0.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.</p><p><strong>Conclusion: </strong>Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/showproj.html?proj=180456, China Clinical Trial Registry (ChiCTR2200064733).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1526890"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is transphyseal intramedullary fixation of the distal radius in pediatric fractures a safe procedure? An MRI study.","authors":"Marco Giordano, Michela Florio, Silvia Careri, Marco Cirillo, Angelo Gabriele Aulisa, Fabio Massimo Pezzoli, Francesco Falciglia","doi":"10.3389/fsurg.2025.1520712","DOIUrl":"https://doi.org/10.3389/fsurg.2025.1520712","url":null,"abstract":"<p><strong>Background: </strong>Radius and ulna fractures are very common in the pediatric population. Despite the use of pinning through the growth plate, which was proposed in the past and is still being used to treat these fractures, an instrumental validation to define this procedure as safe has not yet been done. Because of this, in the absence of reliable data regarding the passage of fixation devices through the growth plate, most surgical techniques used for treating radius and ulna fractures are based on absolute respect for the growth cartilage. We conducted an MRI pilot study to evaluate the presence of any growth disturbances, bone bridge formation across the physis, or premature closure of the cartilage, to verify the correlation between wire diameter and the percentage of lesions tolerated by the growth plate and to confirm the safety of the trans-physeal pinning procedure. To specifically avoid the wrist fracture healing process near the growth plate as possible bias of the study, we enrolled only patients with mid-shaft forearm fractures.</p><p><strong>Materials and methods: </strong>We evaluated 26 patients with diaphyseal forearm fractures who underwent intramedullary percutaneous transphyseal fixation of the distal radius with a Kirschner wire. Intramedullary K-wire and plaster cast were removed, without a second surgery or anesthesia, about 35-40 days after surgery. A clinical and radiographic evaluation was performed at 1, 3, 6 and 12 months from surgery. We conducted a comparative MRI evaluation of both wrists 12 months after the removal of the K-wire to exclude any growth plate damage related to the passage of the wire through it.</p><p><strong>Results: </strong>clinical data underlined excellent results in most patients. Radiographic healing was achieved in all cases at three months. No significative cartilage disturbances related to the procedure were found in any patient. An asymmetrical bridge that did not correspond to the wire position was found in some older patients, probably related to the initial phase of the growth plate closure process.</p><p><strong>Conclusion: </strong>This study demonstrates that the percutaneous trans-physeal technique could become a valid alternative to the standard method, offering a rapid learning curve, shorter surgical times, and reduced healthcare costs.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1520712"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal natural orifice transluminal endoscopic surgery for early-stage ovarian cancer and borderline ovarian tumors: a case series.","authors":"Gaétan Kellerhals, James Nef, Yannick Hurni, Daniela Huber","doi":"10.3389/fsurg.2025.1542486","DOIUrl":"10.3389/fsurg.2025.1542486","url":null,"abstract":"<p><strong>Introduction: </strong>Surgery is the cornerstone of ovarian cancer treatment. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is a novel, minimally invasive technique that is gaining interest in gynecological oncology. However, its use in ovarian cancer is still limited, with only a few cases reported. This study aimed to evaluate the feasibility of vNOTES for the surgical staging of borderline and early-stage ovarian cancer.</p><p><strong>Methods: </strong>We retrospectively reviewed all cases of borderline ovarian tumors (BOTs) and early-stage ovarian cancer surgically staged by vNOTES at our institution between October 2021 and August 2024.</p><p><strong>Results: </strong>Eleven patients were included, seven with early-stage ovarian or tubal cancer and 4 with BOTs. The median age was 47 (27-81) years, and the median body mass index was 28.1 (22.4-39.2) kg/m². Complete vNOTES staging was achieved in all cases, including peritoneal washing, unilateral/bilateral salpingo-oophorectomy, abdominal cavity inspection, peritoneal biopsies, infracolic omentectomy, and total hysterectomy when required. The median operating time was 70 (35-138) min, with a median blood loss of 50 (10-100) ml. No intraoperative complications occurred except for one case of minor ovarian spillage. No conversions to conventional laparoscopy or laparotomy were needed. Postoperative complications included one surgical site infection (9.1%) and 2 cases of postoperative cystitis (18.2%). No severe complications graded ≥3 on the Clavien-Dindo classification were observed.</p><p><strong>Conclusion: </strong>vNOTES appears to be a feasible approach for the surgical staging of highly selected patients with early-stage adnexal malignancies. Further studies are needed to validate its long-term safety and oncological outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1542486"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research trends and hotspots of Colles fracture: a bibliometric analysis from 1980 to 2023.","authors":"Chaoxi Zhou, Guangrong Yu, Qinglei Wang","doi":"10.3389/fsurg.2025.1509556","DOIUrl":"10.3389/fsurg.2025.1509556","url":null,"abstract":"<p><strong>Background: </strong>Colles fractures, a common type of distal radius fracture, predominantly affect older adults and are often associated with osteoporosis. Understanding the epidemiology, treatment methods, and complications of Colles fractures is crucial for improving patient outcomes.</p><p><strong>Objective: </strong>This bibliometric analysis aims to assess the trends, influential research, and collaboration patterns in Colles fracture studies from 1980 to 2023, providing insights into emerging areas of research.</p><p><strong>Methods: </strong>Literature was retrieved from the Web of Science Core Collection (WoSCC), Science Citation Index Expanded (SCI-EXPANDED) using the search term \"Colles fracture\". A total of 948 relevant documents, including 901 articles and 47 reviews, were analyzed. VOSviewer, CiteSpace, and bibliometrix were utilized for visualization and data analysis, focusing on publication trends and hotspots.</p><p><strong>Results: </strong>The analysis revealed a steady increase in publications and citation counts, peaking around 2010, with a notable decline in publication output post-2010 while citations continued to rise. The USA led in both publication volume and citation impact, with significant contributions from England, Canada, Germany, and Japan. Key authors such as Cooney WP and Jupiter JB were identified as influential, while the Journal of Hand Surgery-American Volume emerged as the leading publication outlet. Keyword analysis indicated a growing emphasis on epidemiology and outcomes research, reflecting broader public health concerns.</p><p><strong>Conclusion: </strong>This bibliometric analysis highlights the evolving research on Colles fractures from 1980 to 2023. Despite a plateau in publication rates, citations continue to increase, indicating the lasting influence of earlier studies. Significant advancements have been made in treatment methods, particularly in external fixation (EF) and open reduction internal fixation (ORIF). The growing interdisciplinary focus on Colles fractures, osteoporosis, and rehabilitation underscores the need for continued research to enhance clinical outcomes and preventive measures.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1509556"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the role of nursing interventions in enhanced recovery after surgery for minimally invasive spine surgery: a retrospective analysis.","authors":"Dan Zhang, Hongmei Ding, Caiping Shen, Yanyan Liu, Nan Jia","doi":"10.3389/fsurg.2025.1519135","DOIUrl":"10.3389/fsurg.2025.1519135","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) protocols have revolutionized postoperative care, particularly in minimally invasive spine surgery (MISS). This study aims to evaluate the role of nursing interventions in improving patient outcomes and reducing healthcare costs within this framework.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated 150 patients undergoing MISS at The First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2017 to December 2021. Of these, 75 were assigned to the conventional group and 75 to the ERAS group. The study compared conventional nursing care with the ERAS protocol, assessing clinical outcomes and hospital expenses.</p><p><strong>Results: </strong>The analysis revealed that implementing targeted nursing interventions significantly decreased the length of hospital stay (LOS) in the ERAS group compared to the conventional group (3.2 days vs. 4 days; <i>p</i> <i><</i> 0.001). Moreover, the multivariate analysis demonstrated that the patients in the the conventional group had significantly higher odds of prolonged length of stay (LOS) as compared to the ERAS group (OR: 5.114; 95% CI: 2.345-11.152, <i>p</i> < 0.001). Furthermore, postoperative drainage volumes were markedly lower in the ERAS group than in the conventional cohort (<i>p</i> < 0.001). Opioid consumption was also reduced, with only 24% of patients in the ERAS group requiring opioids, compared to 45.3% in the conventional care group (<i>p</i> <i>=</i> <i>0.01</i>). Additionally, the ERAS protocol resulted in lower overall hospital expenses, highlighting its cost-effectiveness in enhancing patient outcomes.</p><p><strong>Conclusion: </strong>The implementation of targeted nursing interventions within the ERAS protocol significantly improves patient outcomes in MISS. The ERAS group demonstrated shorter hospital stays, reduced postoperative drainage, and lower opioid requirements compared to the conventional care group. Additionally, the cost-effectiveness of the ERAS protocol highlights its potential to enhance overall healthcare efficiency.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1519135"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing mid-term outcomes and patient satisfaction between percutaneous endoscopic lumbar discectomy and microendoscopic discectomy for foraminal and extraforaminal lumbar disc herniations: a retrospective matched cohort study.","authors":"Sen Liu, Feng Zhao, Chun-Ping Yin, Chao-Hua Zhu, Ruo-Yu Zhao, Guo-Bin Liu, Gang Ji, Jia Chen, Hong-Yang Gao","doi":"10.3389/fsurg.2025.1554970","DOIUrl":"10.3389/fsurg.2025.1554970","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the mid-term outcomes and patient satisfaction between percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) for the treatment of foraminal and extraforaminal lumbar disc herniations.</p><p><strong>Methods: </strong>A retrospective matched cohort study was conducted, including patients diagnosed with foraminal or extraforaminal lumbar disc herniations who underwent PELD or MED between January 2014 and December 2021. Patient demographics, clinical characteristics, and perioperative data were analyzed. Primary outcomes included Visual Analog Scale (VAS) scores for pain, Japanese Orthopaedic Association (JOA) scores and improvement rates for functional status, and overall satisfaction at a minimum 2-year follow-up.</p><p><strong>Results: </strong>A total of 133 patients were included in the final analysis. The PELD group demonstrated a significantly greater reduction in VAS scores for low back pain (6.74 ± 1.21 to 1.95 ± 0.42) compared to the MED group (6.93 ± 1.17 to 2.35 ± 0.89) at the 2-year follow-up (<i>p</i> < 0.001). Both groups exhibited significant improvements in JOA scores, with no notable differences observed at the final follow-up. Patient satisfaction rates were higher in the PELD group, with 86% reporting high satisfaction compared to 72% in the MED group; however, this difference was not statistically significant. Logistic regression analysis identified VAS scores for low back pain, operation cost, and symptom recurrence as independent factors influencing patient dissatisfaction at 2 years post-surgery.</p><p><strong>Conclusion: </strong>Both PELD and MED demonstrated efficacy in treating foraminal and extraforaminal lumbar disc herniations over a 2-year follow-up period. PELD, however, exhibited superior relief of low back pain. Factors, such as low back pain intensity, surgical costs, and symptom recurrence significantly impacted patient dissatisfaction, despite comparable overall satisfaction rates between the two surgical techniques.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1554970"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of percutaneous cement discoplasty combined with PVP for the treatment of stage III Kümmell disease with an adjacent disc vacuum sign.","authors":"Liehua Liu, Pei Li, Lei Luo, Chen Zhao, Huilin Zhang, Deqiang Liu, Qiang Zhou","doi":"10.3389/fsurg.2025.1538964","DOIUrl":"10.3389/fsurg.2025.1538964","url":null,"abstract":"<p><strong>Objective: </strong>To observe the efficacy of percutaneous cement discoplasty (PCD) combined with PVP for the treatment of stage III Kümmell disease (KD).</p><p><strong>Methods: </strong>A total of 33 patients with stage III KD who underwent surgical treatment were divided into the PCD + PVP (PP) group (<i>n</i> = 20) and the internal fixation and fusion (IFF) group (<i>n</i> = 13). The observation indices included demographic characteristics, perioperative information, and clinical and imaging indicators, including the visual analog score (VAS), Oswestry disability index (ODI), Cobb angle, and height ratio of the injured vertebra and its adjacent intervertebral disc (H_v ₊ _d, RH_v ₊ _d).</p><p><strong>Results: </strong>The operation time, blood loss, duration of bedrest, length of stay and cost of hospitalization were significantly lower in the PP group than in the IFF group (<i>P</i> < 0.001). There were no significant differences in the VAS score or ODI between the two groups before the operation, after the operation or at the last follow-up (<i>P</i> > 0.05). The RH_v ₊ _d in the IFF group was significantly higher than that in the PP group after surgery and at the last follow-up (<i>P</i> < 0.05). The Cobb angle in the IFF group was significantly smaller after the operation than before the operation (<i>P</i> = 0.007). The incidence of complications in the PP group was lower than that in the IFF group (<i>P</i> = 0.018).</p><p><strong>Conclusions: </strong>PCD combined with PVP for the treatment of stage III KD with an adjacent disc vacuum sign is effective and may be the next best thing to IFF, especially for elderly patients with complex underlying diseases and great surgical risks.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1538964"},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of one-hole split endoscopy vs. unilateral biportal endoscopy for the treatment of single-segment lumbar spinal stenosis: a retrospective study with 2-year follow-up.","authors":"Peidong Qing, Wenlong Guo, Shiming Xie, Shengxin Zhao, Liqiang Cui, Mingfan Li, Shuangquan Gong, Youpeng Hu","doi":"10.3389/fsurg.2025.1495741","DOIUrl":"10.3389/fsurg.2025.1495741","url":null,"abstract":"<p><strong>Background: </strong>One-hole split endoscopy (OSE) is a novel endoscopic technique proposed by Chinese scholars in recent years. Currently, data is lacking regarding the long-term efficacy of OSE for treating lumbar spinal stenosis (LSS). This study aimed to compare the long-term efficacy of OSE and unilateral biportal endoscopy (UBE) in LSS treatment.</p><p><strong>Methods: </strong>The clinical data of 77 patients diagnosed with LSS at our hospital between January 2020 and March 2022 were retrospectively analyzed. Forty-one patients were treated with OSE, and 36 were treated with UBE. Perioperative indicators such as operation time, blood loss, fluoroscopy times, incision length, hospital stay, follow-up time, complications, and C-reactive protein level preoperatively and 3 days postoperatively were recorded. Visual analog score (VAS) and Oswestry disability index (ODI) were recorded preoperatively and at 1, 3, 6, 12, and 24 months postoperatively to evaluate pain and functional disability. The dural sac cross-sectional area (CSA), lumbar range of motion (ROM), and sagittal translation (ST) of the surgical segment were recorded preoperatively and 3 days postoperatively to evaluate lumbar stability. Clinical efficacy was assessed at the final follow-up using the modified Macnab criteria.</p><p><strong>Results: </strong>VAS and ODI scores significantly improved at each postoperative follow-up in both groups compared with preoperative values (<i>P</i> < 0.05), with no significant difference between the groups (<i>P</i> > 0.05). However, OSE had a shorter operation time, less blood loss, and shorter incision length than UBE (<i>P</i> < 0.05). Postoperative CSA was significantly increased compared to the preoperative CSA (<i>P</i> < 0.05), with no significant difference between the groups (<i>P</i> > 0.05). Postoperative ROM and ST increased; however, there was no significant difference compared to preoperative values (<i>P</i> > 0.05). The complication rates in the OSE (<i>n</i> = 2, 4.88%) and UBE (<i>n</i> = 2, 8.33%) groups were not significantly different (<i>x</i> ² = 0.023; <i>P</i> = 0.880). Clinical efficacy was assessed at the last follow-up using the modified MacNab criteria. Thirty-eight (92.68%) and 34 (94.44%) patients in the OSE and UBE groups, respectively, demonstrated excellent or good efficacy, with no significant difference in the efficacy rate between the groups (<i>x</i> ² = 0.151, <i>P</i> = 0.985).</p><p><strong>Conclusion: </strong>OSE and UBE showed satisfactory long-term efficacy and safety for LSS treatment. However, OSE has a shorter operation time, less blood loss, and shorter incision length, and can be an alternative to UBE.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1495741"},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}