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BACKGROUND: Lumbosacral vertebral fusion operation is an important treatment for lumbosacral vertebral degenerative disease. Traditional open surgery has great trauma; postoperative recovery time is longer; there are more complications. To reduce the damage to normal tissue and increase the rate of healing, scholars in and outside China improve the lumbar spine fusion surgery, and lumbar fusion becomes a tendency of the development of minimally invasive surgery. In 2004, Cragg introduced lumbosacral vertebral axial fusion (AxiaLIF, axial lumbar intervertebral fusion). The operation is through posterior rectal wall and presacral space approach, axially nailing for fusion of L5/S1. Muscle, ligament and blood vessels of the spine were retained. Mechanical stability was similar to that of traditional fusion. Osseous fusion rate was high at the operation segment. This is in line with the concept of minimally invasive surgery of the spine. OBJECTIVE: To summarize the advantages and disadvantages of traditional and present fusion techniques from traditional lumbar fusion and present lumbar fusion angle, and to explore the application of AxiaLIF in lumbosacral fusion. METHODS: We retrieved PubMed, Web of Science, and Springer database with the English key words of "Axial interbody fusion and (properties or evaluation), biomechanics, spine mechanical test, spine and (kinematics or motion)", and Chinese Journal Full-Text Database with the Chinese key words of "Axial fusion, biomechanics research assessment, biomechanics, anterior sacral space, minimally invasive spine" for studies concerning lumbar fusion, complications, biomechanics, and humanistic medicine that had been published in recent 5 years. Repetitive studies were excluded, and 46 studies were analyzed and discussed. RESULTS AND CONCLUSION: In the past 90 years, scholars in and outside China had studied the methods of lumbar fusion from various levels, analyzed and summarized the advantages and disadvantages of various operative methods, and identified the indications of lumbar spinal fusion. By comparing characteristics of open surgery and minimally invasive surgery, this study suggested that minimally invasive lumbar fusion has become a trend. In-depth understanding of biomechanical stability, complications, and postoperative recovery time after AxiaLIF is still a long way to go in future medical research.
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<p><b>OBJECTIVE</b>To investigate the occurrence of germ cell apoptosis and the expression of Bcl-2/Bax after aniso-doses arsenic (As2O3) administration in the testes of the adult male rats.</p><p><b>METHOD</b>Forty healthy male Sprague-Dawley rats were divided randomly into four groups and were administered respectively with 0 (control group), 0.375, 0.75, 1.5 mg x kg(-1) of As2O3 by intragastric administration consecutively for 16 weeks. The numbers of testicular sperm head were counted and the coefficient of testicular viscera and daily sperm production (DSP) were calculated in every group. The apoptosis of germ cell were assessed by in situ terminal deoxynucleotityl transferase mediated dTUP nick end labeling (TUNEL) technique. The expression of Bel-2/Bax in spermatogenic cells of different grades were located and quantitated by the method of immunohistochemistry.</p><p><b>RESULT</b>(1) In the testes of As2O3-treated rats, the coefficient of testicular viscera, the number of testicular sperm head and DSP in the middle and high dose groups decreased significantly, compared with those in the control group (P < 0.01); however the apoptosis index of germ cell (AI) significantly increased compared with that in the control group (P < 0.01). Bcl-2 expression of middle dose group and high dose group decreased significantly compared with that in the control group (P < 0.01). Bax expression of middle dose group and high dose group increased significantly compared with that in the control group (P < 0.01); (2)The dependability analysis between DSP and AI showed a negative correlation (r = -0. 563, P <0. 01). (3) The negative correlation was significant between AI and Bcl-2 expression of spermatogenic cells (r = -0.825, P < 0.01); The positive correlation was significant between AI and Bax expression of spermatogenic cells (r = 0.710, P < 0.01).</p><p><b>CONCLUSION</b>One of the mechanisms of male reproduction toxicity of As2O3 might be that Bcl-2 expression is inhibited and Bax expression is encouraged which induces the decrease of quantity of sperm cells.</p>