Intervention Mechanism of Yishen Huayu Prescription on Glomerular Podocyte Injury in Diabetic Nephropathy Rats Based on EMT Regulated by Wnt/β-catenin Pathway / 中国实验方剂学杂志

Objective:To investigate the intervention mechanism of Yishen Huayu prescription on glomerular podocyte injury in diabetic nephropathy （DN） rats based on epithelialmesenchymal transition （EMT） regulated by Wnt/<italic>β</italic>-catenin pathway. Method:The 60 SD rats were divided into control group， model group， Wnt-C59 group （0.03 g·kg^-1 Wnt/<italic>β</italic>-catenin pathway inhibitor）， low-dose group （8 g·kg^-1）， medium-dose group （16 g·kg^-1） and high-dose group （32 g·kg^-1）. After 12 weeks， various indexes ， including general signs， serum creatinine （SCr）， blood urea nitrogen （BUN）， renal index， urinary protein， blood glucose， renal pathological changes， podocyte and expressions of glomerular basement membrane injury and podocyte injury related proteins ［nephrin， synaptopodin］， Wnt/<italic>β</italic>-catenin pathway related proteins （Wnt1， <italic>β</italic>-catenin）， podocyte EMT related protein ［<italic>α</italic>-smooth muscle actin （<italic>α</italic>-SMA）， E-cadherin］， were compared between groups. Result:Compared with the control group， the renal tissue in the model group showed significant pathological changes， including diffuse thickening of glomerular mesangial matrix and severe foot process fusion， and a significant increase in SCr， BUN， renal indexes， urinary protein， blood glucose， Wnt1， <italic>β</italic>-catenin， and <italic>α</italic>-SMA expression levels （<italic>P</italic><0.05） as well as a significant decrease in nephrin， synaptopodin and E-cadherin expression levels（<italic>P</italic><0.05）. Compared with model group， SCr， BUN， renal index， urinary protein， blood glucose， Wnt1， <italic>β</italic>-catenin， and <italic>α</italic>-SMA expression levels in each intervention group significantly decreased （<italic>P</italic><0.05）， while the expression levels of nephrin， synaptopodin and E-cadherin significantly increased （<italic>P</italic><0.05）. Among intervention groups， the improvement of above indexes in high-dose Yishen Huayu prescription group was the most obvious （<italic>P</italic><0.05）， which was similar to the effect in Wnt-C59 group. Conclusion:Yishen Huayu prescription prevents podocyte EMT by inhibiting Wnt/<italic>β</italic>-catenin pathway， thereby repairing glomerular podocyte injury in rats with diabetic nephropathy.

Preliminary curative effect of interspinous blocking injection guiding by X-ray for the diagnosis and treatment of lumbar Baastrup's disease / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.</p><p><b>METHODS</b>From November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.</p><p><b>RESULTS</b>All patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.</p><p><b>CONCLUSION</b>Fluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.</p>

Laminectomy and extraction of nucleus pulposus for treatment of lumbar disc herniation: effect evaluation of over 10-year-followed-up / 中国骨伤

<p><b>OBJECTIVE</b>To investigate retrospectively the clinical effects and recurrence rate of 143 cases who underwent one level discectomy and followed up more than 10 years. To evaluate the outcome of patients in groups of different operating age and extents of disc herniation, and analyse whether difference exists in each group.</p><p><b>METHODS</b>There were 143 patients (operation time from January 1996 to December 2000) including 80 males and 63 females, aged from 18 to 66 years old with an average of 37.85 years. The followed-up time was 10 to 15 years with an average of 12.7 years. Patients were divided into 3 groups depends on operating age: < 30 years old, 30 to 50 years old and > 50 years old; 87 patients who's pre-operative CT scan could be collected among 143 cases were divided into 3 groups depends on extents of disc herniation: I degree, II degrees, and III degrees. The final followed-up was obtained in 2011, to evaluate each group and the holistic clincal outcome with JOA scores and ODI scores, and observe whether there were difference between every groups; to judge the effects by patient himself with modified Macnab Criteria.</p><p><b>RESULTS</b>(1) JOA scores pre-operation and final followed-up was 5.11 +/- 2.02 and 12.51 +/- 2.35 respectively; ODI scores pre-operation and final followed-up was 33.98 +/- 7.42 and 13.39 +/- 6.79 respectively. There were significant differences between pre-operative and final followed-up in JOA and ODI (P < 0.01). The excellent-good rate was 83.2% (119/143 ) according to modified Macnab Classification with recurrence rate of 6.3% at final follow-up. (2) Obvious difference was found in JOA scores in group who's age at operation less than 30 years old compared with other 2 groups at followed-up time, and no significant difference was found in JOA scores between other two groups ; no significant difference was found in ODI scores among the three groups. (3) Significant difference was found in JOA and ODI scores in group with III degrees lumbar disc herniation group compared with other 2 groups, and no statistical difference was found in clincal scores between other 2 groups.</p><p><b>CONCLUSION</b>(1) Long-term followed-up of 143 cases prove mono-level lumbar discectomy is an option for disc herniation with good curative effect and lower recurrent rate, the technique should be the prior selection in dealing with patients with lumbar disc herniation. (2) 51% patients (19/37) in group under 30 years old endure persistent low back pain. (3) The long-term clinical effects in patients with severe disc protrution who underwent lumbar discectomy is worse than those patients with mild lumbar disc herniation.</p>

Karyotype and pollen morphology of main Fritillaria thunbergii cultivars / 中国中药杂志

<p><b>OBJECTIVE</b>To study the differences in pollen morphology and karyotype among main Fritillari thunbergii cultivars.</p><p><b>METHOD</b>Pollen morphologies of three F. thunbergii cultivars were examined by scanning electron microscopy (SEM), and the chromosome numbers and karyotypes were studied by applying traditional squash technique.</p><p><b>RESULT</b>The pollen shape of F. thunbergii (Xiaye) was ovoid, while those of the other F. thunbergii (Kuanye, Duozi) were oblong. There were significant differences in mesh ridge width, mesh size among three F. thunbergii cultivars. The karyotype formula ofthree cultivars were as follows: F. thunbergii (Xiaye) was 2n =2x =3m +1sm + 8st(2SAT) + 12t(4SAT), F. thunbergii (Kuanye) was 2n = 2x =2m + 2sm + 10st(2SAT) + 10t (2SAT), F. thunbergii (Duozi) was 2n =2x = 24 =2m +2sm +5st(2SAT) +15t(4SAT). The three cultivars of karyotype belonged to 3B; There were the heterozygosity of homologous chromosome in both F. thunbergii (Xiaye) and F. thunbergii (Duozi).</p><p><b>CONCLUSION</b>The genetic diversity of F. thunbergii is very rich, which could enhance the adaptability, and lay the foundations for new variety selection of F. thunbergii.</p>

Surgical treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical outcome of the treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction and short segment pedicle screw at the fracture level.</p><p><b>METHODS</b>From December 2008 to May 2010,12 cases of traumatic thoracolumbar single compression fracture (T11-L2) were treated, including 9 males and 3 females, with an average age of 35.8 years old (ranging from 24 to 52). There were 2 case with T11 fracture, 2 cases with T12, 6 cases with L1 and 2 cases with L2, without osteoporosis,pathological fractures or neurologic deficits. Radiographic data were collected preoperatively, 5 days postoperatively and at last follow-up (at least 12 months). Cobb's angle, vetebral compression ratio, internal fixation state were observed.</p><p><b>RESULTS</b>All patients were followed up from 12 to 30 months postoperatively,with an average of 19 months. There was no pseudoarticulation and solid bone fusion was achieved in all cases. There were no complications such as loosening or rupturing of internal fixation and so on. Sagittal kyphotic Cobb angle was corrected from preoperative (25.8 +/- 9.4) degrees to postoperative (6.7 +/- 2.3) degrees and (6.9 +/- 2.6) degrees at last follow-up. The percentage of vertebral compression was corrected from preoperative (42.5 +/- 10.4)% to postoperative (7.5 +/- 3.9)% and (8.4 +/- 4.5)% at last follow-up.There was significant difference between the postoperative data and preoperative data (P < 0.05), while the difference was not significant between the postoperative data and the last follow-up (P > 0.05).</p><p><b>CONCLUSION</b>The thoracolumbar single compression fracture can obtain and maintain a good restoration by using the technic of in situ rod rotation reduction and short segment pedicle screw at the fracture level. The technique should be highly recommended.</p>

The role of capsaicin-sensitive primary afferents in experimental sciatic pain / 中华外科杂志

<p><b>OBJECTIVES</b>To determine the effect of destroying capsaicin-sensitive primary afferents (CSPA) fibers on paw withdrawal mechanical threshold (PWMT) induced by the direct compression of L5 nerve root with autologous disc.</p><p><b>METHODS</b>The procedure used autologous disc of the rats from the coccygeal intervertebral discs to apply direct pressure to the L5 dorsal root. PWMT was measured at the different time points post-surgery and pre-surgery. The changes in spatial expression pattern of c-fos protein in the spinal cord were also determined at 3 weeks when PWMT decreased to the peak.</p><p><b>RESULTS</b>The pretreatment with capsaicin produced a complete prevention of mechanical hyperalgesia induced by disc compression. The direct compression of L5 nerve root produced an obvious expression of fos-like immunoreactivity neurons in the dorsal horn of the spinal cord, which was significantly decreased by pretreatment with capsaicin.</p><p><b>CONCLUSIONS</b>The study shows that CSPA fibers, which mainly terminated in superficial layers of dorsal horn, may play a key role in mechanical hyperalgesia in the new sciatica model.</p>

Studying the influence of age and short or long segments of pedicle screw instrumentation to the clinical efficacy of early single thoracolumbar fracture / 中华外科杂志

<p><b>OBJECTIVE</b>To study the influence of different age and short or long segments of pedicle screw fixation to the clinical efficacy of early single thoracolumbar fracture.</p><p><b>METHODS</b>From June 2005 to June 2008, 27 patients of early single thoracolumbar fracture were treated using short or long segments pedicle screw instrumentation, fracture vertebral (AO classification: type A1 or A2) was between T11 or L2. All patients were divided into A or B group according to age. A group: 12 cases mean age (32.6+/-10.7) years old (range, 16-55 years old). B group: 15 cases mean age (66.8+/-9.2) years old (range, 56-78 years old). All patients were treated with bony autograft by transpedicular of fracture vertebral and internal fixation by pedicle instrumentation. Pedicle screws were inserted in the pedicles of above and lower adjacent vertebral body of fracture vertebral, and others were inserted in the pedicles of above and lower two vertebral bodies of injured vertebral. Recorded operation time, blood loss and occurrence of complications. All patients took X radiograph plane examination (anterior-posterior position and lateral position) before operation and during 1 week of post operation and more than 1 year of follow up. Measured percentage of anterior compression vertebral high and kyphosis angle of the fracture vertebral by the same one group doctors.</p><p><b>RESULTS</b>Mean follow up time was (29.6+/-9.1) months (range, 10 - 34 months). The patients using short segments pedicle screw fixation in A and B group, mean operation time were (102+/-16) min and (118+/-24) min (P=0.072), mean volume of loss blood were (315+/-87) ml and (331+/-87) ml (P=0.064) respectively. The patients using long segments pedicle screw fixation in A and B group, Mean operation time were (138+/-22) min and (159+/-31) min (P=0.052), Mean volume of loss blood were (446+/-102) ml and (482+/-148) ml (P=0.055) respectively. There was no statistic different significantly between A and B group. The patients using short segments fixation, preoperative, during one week of post operation, one year of follow up, in A group the percentage of anterior compression vertebral high were 41.3+/-14.0, 5.4+/-1.0, 13.6+/-1.1, and 38.5+/-11.2, 8.3+/-2.1, 21.4+/-5.2 in B group. The patients using long segments fixation, at some time of preoperative, during one week of post operation and one year of follow up the percentage of anterior compression vertebral high were 40.8+/-11.5, 4.6+/-1.2, 8.3+/-1.0 in group A, and 44.3+/-10.2, 9.7+/-2.1, 11.2+/-3.0 in group B. In group A and B the kyphosis angle of fracture segment was 17.5 degrees+/-1.0 degrees and 16.3 degrees+/-3.1 degrees before operation, 4.2 degrees+/-1.0 degrees and 6.0 degrees+/-1.1 degrees in one week of postoperation and 11.5 degrees+/-1.0 degrees, 13.4 degrees+/-3.0 degrees in one year later postoperation. All the compression vertebral high was recovered and kyphosis was corrected significantly during one week and one year after operation (P<0.05), but there was some loss of kyphosis correction rate in follow up.</p><p><b>CONCLUSION</b>There is better clinical efficacy of short segments pedicle instrumentation for treating early thoracolumbar fracture in the young group, but long segments fixation of pedicle instrumentation is more suitable for the older group.</p>

Correlation between high intensity zone on MRI and positive pain response on lumbar discography in the diagnosis of discogenic low back pain / 中华外科杂志

<p><b>OBJECTIVE</b>To study correlation between high intensity zone (HIZ) of lumbar disc and positive pain response on lumbar discography for the diagnosis and treatment of discogenic low back pain.</p><p><b>METHODS</b>Thirty-seven cases with chronic low back pain without neurologic symptoms and lumbar disc herniation on CT scan underwent lumbar discography and MRI examination. X-ray and CT after discography with positive pain response were analyzed to correlate with HIZ on MRI.</p><p><b>RESULTS</b>Ninety-eight discs underwent discography in 37 patients. Twenty-one discs presented positive pain response; including 10 have HIZ (47.6%). Seventy-seven discs presented negative pain response; including 29 had HIZ (37.6%). The higher grade of annular disruption group had the higher proportion of HIZ on lumbar MRI. There was a positive correlation between HIZ and degree of annular disruption. However, there was no correlation between HIZ and positive pain response on lumbar discography.</p><p><b>CONCLUSIONS</b>HIZ on lumbar MRI only can be a filtrated and suggestive image sign and can not replace discography in the diagnosis and treatment of discogenic low back pain.</p>

Diagnosis and surgical treatment of back pain originating from endplate / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the methods of diagnosis and surgical treatment for patients with back pain originating from endplate.</p><p><b>METHODS</b>All patients received examinations of radiography, CT, and MR imaging. Pain level of disc was decided by discography in each patient. The principal outcome judgment were pain and disability, and the efficacy of surgical treatment was assessed by visual analog scale (VAS) for pain, and the Oswestry disability index (ODI) for functional recovery.</p><p><b>RESULTS</b>All patients with a diagnosis of back pain originating from endplate according to discography were treated with anterior or posterior fusion surgery. The mean follow-up period was three years and five months (from 2 to 6 years). Among of the 21 patients, 20 (95%) reported a disappearance or marked alleviation of low back pain, and experienced a definite improvement in physical function. A statistically significant and clinically meaningful improvement on the ODI and the VAS scores were obtained in the patients with chronic low back pain originating from endplate (P = 0.0001) after treatment.</p><p><b>CONCLUSIONS</b>The study suggests that the discography and fusion surgery may be very effective methods for the diagnosis and treatment of chronic back pain originating from endplate respectively.</p>

Unilateral external fixator in the treatment of lower third humeral shaft fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To retrospectively analyze the effect of unilateral external fixators in the treatment of lower third humeral shaft fractures.</p><p><b>METHODS</b>From October 1997 to October 2003, 33 patients aged 15 -70 years (average 31 years) with lower third humeral shaft fractures were treated with unilateral external fixators. There were 9 spiral fractures (type A1), 1 oblique fracture (type A2), 3 transverses fractures (type A3) and 20 comminuted fractures (11 type B1, 9 type B2) according to AO classification. Fifteen cases were treated with open reduction and limited internal fixation and fixation with external fixators, 10 cases treated with open reduction and fixation with external fixators, and 8 cases treated with closed reduction and fixation with external fixators. Nerve exploration was undertaken in 9 cases with preoperative radial nerve injury. External fixators were removed after bone healing. The average follow-up was 18 months with a range from 8 to 24 months.</p><p><b>RESULTS</b>The time of bone healing ranged 11-22 weeks (average 14 weeks). The latest follow-up showed the functions of 9 cases of preoperative radial nerve injury and of 2 cases postoperative radial nerve injury and the function of elbow were recovered to normal. There were only 7 cases of superficial infection at pin hole, which was subsided by using oral antibiotics and pin-hole care with mild disinfectants.</p><p><b>CONCLUSIONS</b>Fixation with unilateral external fixators combined with open reduction and limited internal fixation has a good effect in the treatment of lower third humeral shaft fractures.</p>

The pathogenesis of discogenic low back pain / 中华外科杂志

<p><b>OBJECTIVE</b>To study the pathogenesis of the pain of discography and the discogenic low back pain.</p><p><b>METHODS</b>19 specimens of lumbar intervertebral discs from 17 patients with discogenic low back pain during posterior lumbar interbody fusion, and 12 physiologically aging discs and 10 normal control discs were collected to investigate the morphologic features and innervation containing neuropeptides substance P (SP), neural filament (NF), and vasoactive-intestinal peptide (VIP).</p><p><b>RESULTS</b>The distinct morphologic characteristic of the disc from the patient with discogenic low back pain was the formation of the strip zone of vascularized granulation tissue from the nucleus pulposus to the outer part of the annulus fibrosus in which there was one or several fissures. The structure of annulus fibrosus beyond the strip zone of granulation tissue was basically normal. The structures of the aging discs and the control discs showed the age-related changes. The innervation of SP, NF and VIP immunoreactive nerve fibers in the painful discs was more extensive compared with the aging discs and the control discs. The nerve in growth deep into annulus fibrosus and nucleus pulposus was observed mainly along the strip zone of granulation tissue in the painful discs.</p><p><b>CONCLUSIONS</b>Findings indicate that the strip zone of granulation tissue with extensive innervation in the posterior part of the painful disc is the original site of the pain of discography and the discogenic low back pain. The strip zone of granulation tissue might originate from the injury and subsequent reparation of the margin of annulus fibrosus. The difference of the aging disc and painful disc which can not be differed each other on MRI is the formation of the strip zone of granulation tissue along tear histologically in posterior part of the painful disc.</p>

The use of dynamic axial external fixator with modified technique in Pilon fractures of tibial / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively analyses the results of dynamic axial external fixator with modified technique in the treatment of severely Pilon fractures.</p><p><b>METHODS</b>From July 2000 to February 2003, 14 patients with severely Pilon fractures were treated with dynamic axial external fixator inserted with modified technique combined with limited open reduction and internal fixation with screws and Kirschner wires, with two distal external pins inserted into talus and calcaneus respectively so that the rotation axis of distal clamp was coincided with that of ankle joint. All patients were young or middle-aged people from 20 y to 52 y (average 38 y). All fractures were Rüedi-Allg were type II or type III. External fixators were removed after bone healing. Duration of follow-up was 5 - 36 m (average 18 m).</p><p><b>RESULTS</b>The time of bone healing was 12 - 24 weeks (average 14 weeks). At the latest follow-up, results include 5 excellent, 6 good and 3 fair according to ankle scoring system (ASS). There was only one case of superficial pin site infection settled with oral antibiotics and pin site care with mild disinfectants. There was no wound breakdown, superficial and deep infection, osteomyelitis, fracture fragments redisplacement and collapse.</p><p><b>CONCLUSION</b>Dynamic axial external fixator with modified technique combined with limited internal fixation is an effective method for the treatment of severely Pilon fractures.</p>

Effect of lumbar protective belt on prevention of low back fatigue in personnel during simulated driving / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe low back fatigue of subjects before and after simulated driving, and to study the role of the belt used in prevention of low back fatigue of drivers during driving.</p><p><b>METHODS</b>To assess the changes in median frequency (MF), mean power frequency (MPF) of surface electromyogram (SEMG), and flicker frequency, visuognosis persistence of drivers with and without protective belt in simulated driving.</p><p><b>RESULTS</b>There were significant differences in MF [(47.35 +/- 6.07), (39.26 +/- 5.79), (47.21 +/- 6.02), (43.44 +/- 6.26) Hz respectively], MPF [(69.86 +/- 7.08), (59.12 +/- 7.19), (69.86 +/- 7.08), (63.88 +/- 7.49) Hz respectively] between before and after simulated driving without or with the special belt (P < 0.01). But no differences in MF or MPF between without and with the belt before simulated driving were found (P > 0.05). The flicker frequency [(35.64 +/- 2.82), (42.31 +/- 4.68), (35.96 +/- 3.05), (39.79 +/- 3.36) Hz], visuognosis persistence (65.77% +/- 3.94%, 56.83% +/- 5.68%, 65.88% +/- 3.92%, 62.27% +/- 2.91%) had some changes too.</p><p><b>CONCLUSION</b>Simulated diving could induce fatigue of back muscle in drivers. However, the protective belt can effectively prevent low back fatigue of drivers in simulated driving.</p>

Correlation analysis of impact positions on the head and hyperextension severities of cervical spinal cord / 中华创伤骨科杂志

Objective To analyze the correlation between impact positions on the head and hyperextension severities of cervical spinal cord,as well as their treatment.Methods A retrospective analysis was done for 41 cases of hyperextension of cervical spinal cord without fracture-dislocation who had received management in our department from January 1999 to January 2004.All the patients had no cervical disorders before injuries.They were injured by impact mostly on the forehead,cheek or lower mandible.Their neurological findings at admission and 6-month follow-ups were assessed according to ASIA (American Spinal Injury Association) rating system.Results Of the 20 patients who were injured by impact on the forehead,four were rated in neural function as grade B,11 as grade C,and five as grade D at admission,while one as grade C,11 as grade D,and eight as grade E at 6-month follow-up.Of the 12 patients who were injured by impact on the cheek,one was rated in neural function as grade B, four as grade C,and seven as grade D at admission,while one as grade C,two as grade D,and nine as grade E at 6-mouth follow-up.Of the nine patients who were injured by impact on the lower mandible,five were rated in neural function as grade B,three as grade C,and one as grade D at admission,while two as grade B,five as grade C,and two as grade E at 6-month follow-up.The 6-month follow-ups after treatment showed that the neural function was rated below grade C in nine patients,seven of whom had been injured by impact on mandible.Two patients of grade B who showed little improvement after treatment had been injured also by impact on mandible.Conclusion Impact on the lower mandible causes mote severe hyperextension than impact on tbe cheek or forehead.Both rea- sonable non-operative and operative treatments can lead to satisfactory outcome for patients with hyperextension of cervical spinal cord but without fracture-dislocation.

The diagnosis and treatment of lumbar internal disc disruption / 中华外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of lumbar internal disc disruption (IDD).</p><p><b>METHODS</b>Thirty-six patients with chronic disabling low back pain proved by discography as IDD were treated with disc excision and lumbar interbody fusion, and 8 cases were treated with PLIF, 28 with ALIF. The clinical results were evaluated by pre- and post-operative VAS, and the fusion results were evaluated by X-ray studies of the lumbosacral spine.</p><p><b>RESULTS</b>The average period of follow-up was 18 months, ranging from 6 to 26 months. Six patients treated with PLIF basically disappeared low back pain, 2 complained of mild back pain; the VAS after operation was decreased significantly in comparison with that of pre-operation (P < 0.01). Twenty-seven treated with ALIF basically disappeared low back pain; the VAS after operation was decreased significantly in comparison with that of pre-operation (P < 0.01). Fusion rate was 88% in patients who were treated with PLIF, and 97% in patients with ALIF.</p><p><b>CONCLUSION</b>Disc excision and interbody fusion is an effective method for the treatment of IDD, but the operation indications should be known well.</p>