Objective To explore the relationship between imbalance in sagittal plane as well as structural factors and lumbar degenerative disease. Methods Patients diagnosed between July 2012 and May 2015 were divided into 4 groups according to corresponding diagnostic criteria: lumbar disc herniation group (LDH), lumbar disc protrusion group (LDP), degenerative lumbar spondylisthesis group (DLS) and nonspecific low back pain group (NLBP); 40 patients were included in each group according to their visiting time. All patients underwent X-ray, CT, and MRI. Sagittal parameters and evaluate degeneration level of structural factors were measured, and the difference among the groups were analyzed. Results There was statistical significance in differences of pelvic incidence (PI) and lumbar lordosis (LL) among 4 groups (P<0.05). Average PI was followed in descending order: DLS, LDP, NLBP, and LDH; average LL was followed in descending order: DLS, NLBP, LDP, and LDH. There was no statistical differences in sacral slope and pelvic tilting among 4 groups (P>0.05). The difference in the level of lumbar disc degeneration between NLBP group (which had slightest lumbar disc degeneration) and the other groups was significant (P<0.001) while no statistical differences in level and rate of lumbar disc degeneration among the other three groups was found (P>0.05). As to the level of lumbar zygapophyseal joint degeneration, there was statistical differences between NLBP group (which had the lowest level of lumbar zygapophyseal joint degeneration) and the other groups (P<0.001) while no statistical differences in the grade of lumbar zygapophyseal joint degeneration among the other three groups (P>0.05). There was statistical differences in the rate of lumbar zygapophyseal joint degeneration between LDH and DLS group (χ2=11.429,P=0.001). Conclusions Vertical lunbar spine is combined with LDH of which the level of lumbar zygapophyseal joint degeneration is minimized, while crooked lunbar spine is combined with DLS of which the level of lumbar zygapophyseal joint degeneration is maximization. NLBP has the lowest level of degeneration of lumbar disc and lumbar zygapophyseal joint degeneration.
Objective To summarize clinical outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases simultaneously. Methods The clinical data of 60 patients with bilateral chest diseases treated by uniportal thoracoscopic surgery via subxiphoid approach in the Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College from August 2016 to December 2017 were retrospectively analyzed. There were 35 males and 25 females, aged 25.5±8.8 years ranging from 13 to 51 years. There were 40 patients wtih palmar hyperhidrosis, and 20 patients with bilateral pulmonary bullae and onset of one-side pneumothorax. All patients adopted subxiphoid uniportal video-assisted thoracoscopic surgery. Among them 36 patients with palmar hyperhidrosis underwent resection of R3 bilateral sympathetic nerves, 1 resection of R4 bilateral sympathetic nerves, 3 resection of R3+R4 bilateral sympathetic nerves, and 20 patients with pulmonary bullae underwent bilateral bullectomy and pleurodesis. Results Fifty-five patients cured within 1 to 4 days and discharged after surgery. One patient with incision infection and pulmonary infection after bullectomy, cured and discharged after 3 weeks anti-inflammation and incision dressing change. Four patients with Grade B healing recovered after 1 to 2 weeks dressing change. During the follow-up, no pneumothorax or hand perspiration relapsed. Conclusion Subxiphoid uniportal video-assisted thoracoscopic surgery for simple bilateral chest disease simultaneously is safe and feasible, which not only avoids simultaneous trauma of bilateral punch, but also alleviates the pain of patients.