Predictive factors for successful sperm retrieval by microdissection testicular sperm extraction in men with nonobstructive azoospermia and a history of cryptorchidism.

This study aims to explore the factors influencing the success rate of the microdissection testicular sperm extraction (Micro-TESE) in patients with nonobstructive azoospermia (NOA) and cryptorchidism. Clinical data of 162 patients with cryptorchidism who underwent Micro-TESE due to infertility from December 2015 to May 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. In the univariate analysis, significant differences in the age of patient at the time of orchidopexy (median [interquartile range, IQR]: 7.0 [4.0-11.0] years vs 11.5 [9.0-14.5] years, P < 0.001), interval between orchidopexy and Micro-TESE (mean ± standard deviation: 17.5 ± 5.0 years vs 14.4 ± 4.4 years, P < 0.001), severity of cryptorchidism (unilateral [62.8%] vs bilateral [31.6%], P < 0.001; location of cryptorchidism, intra-abdominal [27.3%] vs inguinal [44.8%] vs suprascrotal [66.7%], P < 0.001), volume of the dominant testis (median [IQR]: 17.00 [15.00-19.00] ml vs 14.50 [11.75-16.25] ml, P < 0.001), and levels of follicle-stimulating hormone (FSH; P = 0.004) and testosterone (P = 0.006) were observed between the successful and failed sperm extraction groups. After conducting the multivariate analysis, four of these factors, including unilateral/bilateral cryptorchidism (P < 0.001), location of cryptorchidism (P = 0.032), age of orchidopexy (P < 0.001), and dominant testicular volume, were adopted in the clinical prediction model to evaluate preoperatively the success rate of Micro-TESE for patients with NOA and cryptorchidism. The likelihood of successful sperm retrieval by Micro-TESE in men with NOA and cryptorchidism increased in patients with mild forms of cryptorchidism.

[Study on the rotary angle, plain radiographs and CT appearance in unilateral locked facet of cervical spine].

OBJECTIVE: To study the rotary angle and image features, so as to help early diagnosis. METHODS: Four adult cervical spine (C1-T1) specimens were used, including 2 males and 2 females,ranging in age from 28 to 40 years old. X-ray and CT examination were performed before the experiment. C2-C4 and C5-T1 were fixed respectively using self-made clamp. Unilateral locked facet of cervical spine was simulated under the violence of inflection and rotation, in which the muscle contraction was partially simulated, and at last the plain radiographs and CT of unilateral locked facet of cervical spine were analyzed. RESULTS: In unilateral locked facet of cervical spine, the average rotary angle was 19.75 degrees, and average forward shift of vertebral was 3.68 mm. The intervertebral foramina below the injury plane were showed at 0 degrees,10 degrees, 180 degrees,190 degrees; the intervertebral foramina above the injury plane were showed at 150 degrees,160 degrees, 00 degrees, -10 degrees, and the facet was locked or in disorder at the injury plane. The intervertebral foramina at the anterior oblique position was bigger in interlocking side, but it was smaller in the opposite side. CT scan showed rotary spine, the naked facet sign; coronal plane reconstruction showed bilateral asymmetry; sagittal plane reconstruction obviously showed unilateral locked facet. CONCLUSION: X-ray and CT both can independently diagnose unilateral locked facet of cervical spine. CT and three-dimensional reconstruction are more better than X-ray to diagnosing it.

[Radiation exposure to spine surgeon: a comparison of computer-assisted navigation and conventional technique].

To analyze the radiation exposure of surgeon in spine surgery and compare computer-assisted navigation and conventinal technique. While performing spine surgery, the surgeon is exposed to a significant amount of radiation. Spinal surgeons should be considered as workers of radiational occupation accordingly. Methods of reducing radiation exposure should be strongly recommended. Comparing with conventional fluoroscopic technique,the computer-assisted navigtion can reduce surgical time, radiation exposure, and has become an increasingly accepted and practiced from of intraoperative spinal navigation.