Bo Yang

The goal of this study is to compare the therapeutic effectiveness of percutaneous cervical discectomy, percutaneous cervical disc nucleoplasty, and a combination of the two for the treatment of cervical disc herniation and the effective stabilization of the cervical vertebral column. A retrospective study was performed from February 2003 to April 2011. One hundred and seventy-one cervical disc herniation patients with a mean age of 47.8 years (ranging from 21 to 74 years) participated in the study and were treated with the three types of percutaneous minimally invasive techniques: percutaneous cervical discectomy (PCD, 97 cases), percutaneous cervical disc nucleoplasty (PCN, 50 cases), and a combination of the two (PCDN, 24 cases). After treatment, the postoperative clinical results and the stability of the cervical vertebral columns of these three groups were evaluated and compared. Patients in the PCD group received follow-up care for approximately 4.1 years (ranging from 0.2 to 8.5 years), while those in the PCN group received only an average of 2.6 years (ranging from 0.3 to 7.8 years), and the PCDN group received an average of 3.3 years (ranging from 0.2 to 8 years of follow-up). According to the Japanese Orthopedic Association scoring system, the functional scores (JOA scores) differed significantly between the pre- and postoperative patients within the three groups (PCD t = 21.849, P = t = 14.503, P < 0.05; PCDN t = 8.555, P < 0.05). All patients had been successfully operated on by the same spinal surgeon team. According to the Odom criterion, the clinical outcomes were not significantly different for any of the three groups (the recovery rate using the JOA standard evaluation, F = 2.19, P = 0.116, P > 0.05). The percentages of each procedure that received either an excellent or a good rating were PCD at 81.35 %, PCN at 82.44 % and PCDN at 83.19 %. In addition, the clinical success rates among the three were not significantly different (P > 0.05). Notably, there was no postoperative instability of the cervical vertebral column in any of the patients (P > 0.05), and there was no difference in the pre- or postoperative stability of the cervical vertebral columns in each group. Each group achieved good clinical outcomes with this safe, minimally invasive spinal surgery for the treatment of cervical disc herniation. In addition, no postoperative risk of cervical instability was found.

Objective To study the methods for constructing a digitized three‐dimensional (3D) model of a virtual lumbar region and its adjacent structures in order to assist anatomical study and virtual surgery. Methods Images of DSCF5375‐p1 to DSCF5745‐p1 were taken from the database of the digitized Virtual Chinese human of Southern Medical University in Guangzhou. This region encompasses the superior facet joint of L₄ to the inferior edge of the intervertebral body of L₅. The regions of interest were interactively segmented from the images utilizing Adobe Photoshop software. The images were further processed using format conversion and segmentation. Finally, a 3D model of the L_4–5 region and its neighboring structures was reconstructed with the assistance of Mimics 10.01 software. Results A digitized 3D model of this part of the virtual lumbar spine and its adjacent structures was reconstructed. This model allows all constructed structures to be displayed individually or jointly, moved or rotated arbitrarily, setting of different transparencies and convenient measurement of the diameters and angles of the reconstructed structures. The 3D model precisely displays the anatomical relationships between all structures and provides a reliable 3D model for a spinal endoscopic surgery simulation system. Conclusion Visualization of the digitized 3D reconstruction of the virtual lower lumbar region displays this region and its adjacent structures stereoscopically and in actuality, thus providing morphological data concerning anatomy, image diagnosis and virtual operations in this region.