The SRS-22 is used to evaluate clinical outcomes in ankylosing spondylitis kyphosis patients. This study aimed to investigate the relationship between Scoliosis Research Society-22 (SRS-22) domains and satisfaction with management in patients who underwent surgical correction for ankylosing spondylitis kyphosis. The relationship between patient satisfaction and SRS-22 domain scores will feedback abundant information of therapeutic effect and significance for treatment guidance. In this work, 106 patients with ankylosing spondylitis kyphosis at a single institution, who underwent posterior spinal fusion of five levels or more to the sacrum, completed SRS-22 evaluation preoperatively and followed up for a minimum of 2-year postoperation. Wilcoxon tests were performed to compare preoperative with 2-year postoperative scores. Spearman correlations were investigated to evaluate associations between the 2-year treatment satisfaction and therapeutic effect in SRS-22 domain scores. There were 12 females and 94 males with mean BMI of 16.4 kg/m2 and at the mean age of 46.3 years. All of the primary surgeries were treatments performed with mean follow-up of 26 months. A statistical improvement between paired pre- and 2-year postoperative SRS-22 domain scores and most radiographical parameters, commonly P ≤ 0.05, was designed and implemented. The majority of patients gave SRS-22 satisfaction score with 3.0 or more (88.5%) or 4.0 or more (68.8%), which are consistent with the moderate ceiling effect. Spearman coefficient correlations between the SRS-22 domain scores and patient satisfaction were all statistically significant, and they were from low to strong: [Mental (0.30), Activity (0.71), Pain (0.25), and Appearance (0.40)]. Furthermore, correlations for all radiographical and operative parameters were from low to strong. SRS-22 Activity domain correlates strongest with patient satisfaction in ankylosing spondylitis kyphosis patients who have undergone surgical correction at 2-year follow-up.

S1-AI technique may be used as a salvage technique in pelvic fixation of complex spinal deformity surgery. However, the proper detailed parameters in the Chinese population has not been analyzed before to instruct S1-AI screws placement and to ensure the safety of clinical application while the trajectory in pelvic changes significantly at each angle. The ideal S1AI screw trajectory could be obtained in 28 of 30 female patient images (93.3%) and in all of the male patient images (100%). The screws that have already been used clinically in S2AI pathways can be applied in S1AI fixations. It is feasible to place S1AI screws in 93.3% of female Chinese adult patients and in all male Chinese patients. Preoperative CT reconstruction should be performed to evaluate proper trajectory parameters and to avoid anterior violation.

Anterior cervical discectomy and fusion (ACDF) is a commonly used surgical method for the treatment of cervical spondylosis. As ACDF surgery is widely used in clinics, identifying suitable materials to design and prepare cervical interbody fusion cages is a hot research topic. Here, we describe a new three-dimensional (3D) printing approach to create stretchable and tough silk fibroin/nano-hydroxyapatite (SF/nHAp) composites with tunable mechanical properties. The compressive strength of the novel composites with biomimetic structure could reach more than 128 MPa. More importantly, the composites were prepared using 30% silk fibroin and 70% hydroxyapatite, a composition similar to the human bone tissue. Finite element analysis results indicate that the stress distribution of SF/nHAp composite cervical interbody fusion cages in vivo is more uniform than that of commercial Ti alloy cages. This study evaluates the effectiveness of SF/nHAp composites for application in cervical interbody fusion cages and in the field of bone tissue engineering.

Background The purpose of this study was to investigate the clinical efficacy of anatomic reconstruction of the anterior talofbular ligament with preservation of the stump. Methods This retrospective study included 42 patients who underwent an endoscopic lateral ligament reconstruction between from June 2015 to June 2019.Fourteen consecutive patients (10 [71.4%] males and 4 [28.6%] female, mean age 27.79 ± 4.56[range 26 to 36] years) with preserved anterior tibiofibular ligament stump were enrolled in this study.On the other side ,there were 18 patients with unpreserved tibiofibular ligament stumps (unpreserved stump group), 12 males and 6 females, aged 20–36 years, mean (28.56 ± 5.67) years.The functional evaluation was carried out according to the Ankle-Hindfoot Score by the American Orthopaedic Foot and Ankle Society.The Tegner system was used to evaluate range of motion after the index procedure. Ankle proprioception was assessed using the visual analogue scale (VAS) to assess the degree of subjective pain symptoms. Operative time, fever time and wound healing time were also recorded. Results There were no statistically significant differences in postoperative outcomes such as postoperative fever time and wound healing time between the two groups (P > 0.05). The operative time was slightly longer in the stump-preserving group than in the non-stump-preserving group (94.14 ± 11.59 vs. 82.94 ± 15.61 P < 0.05). There were no statistically significant differences in preoperative AOFAS ankle-hindfoot scores, Tegner motor level scores, and VAS scores between patients in the retained-stump group and the non-reserved-stump group (P > 0.05). At 1 year after surgery, the AOFAS ankle-hindfoot scores and Tegner motor level scores improved and the VAS pain scores decreased in both the presurgical and non-presurgical groups. The AOFAS ankle-hindfoot scores and Tegner motion level scores 1 year after surgery were higher in the group with preserved stump than in the group without preserved stump (P < 0.05). Conclusion Arthroscopic reconstruction of the anterior talofibular ligament with and without preservation of the stump can achieve good clinical outcomes. Although arthroscopic anterior talofibular ligament reconstruction with preserved stump prolonged the operative time compared with surgery without preserved stump, it could better improve the subjective ankle function and motion status of patients and improve the prognosis.