Superficial Incision Research Articles

Minimally Invasive Treatment of Moderate Lumbar Spinal Stenosis with the Superion® Interspinous Spacer

Purpose:We evaluated the safety and effectiveness of the minimally invasive Superion® Interspinous Spacer (VertiFlex, Inc., San Clemente, CA) in patients with moderate LSS.Methods:This single-arm prospective study enrolled 121 patients with moderate LSS between February 2008 and August 2009 and were followed up at 1 (n=111), 3 (n=96), 6 (n=81), and 12 (n=52) months. All patients were treated with the Superion Interspinous Spacer. Main outcomes were back function with the Oswestry Disability Index (ODI), extremity and axial pain severity with an 11-point scale, health-related quality of life with the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores from the SF-36, and adverse events through 12 months.Results:ODI improved 64% (p<0.001) through 12 months and clinical success was 92%. Extremity and axial pain improved 53% and 49% (both p<0.001), respectively, through 12 months with clinical success of 76% for axial pain and 86% for extremity pain. Health-related quality of life improved 41% for PCS and 22% for MCS (both p<0.001) through 12 months. PCS clinical success was 81% and MCS clinical success was 62% at 12 months. Four (5.9%) explants were performed although 3 were unrelated to the device. Eight procedure-related adverse events, observed in 6 (5.0%) patients, included superficial incision seroma (n=5), minor wound pain (n=2), and infection (n=1).Conclusions:Preliminary results with the Superion Interspinous Spacer suggest that it is an effective and safe treatment option for patients with moderate LSS who are unresponsive to conservative care.

Evaluation of the histologic reactions to commonly used suture materials in the skin and musculature of ball pythons (Python regius)

To evaluate histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the musculature and skin of ball pythons. 30 hatchling ball pythons. In each snake, ten 1-cm skin incisions were made (day 0). At 8 sites, a suture of 1 of 8 materials was placed in the epaxial musculature, and the incision was closed with the same material. One incision was closed by use of CTA. No suture material was placed in the tenth incision, which was allowed to heal by second intention (negative control). Snakes (n = 5/group) were euthanized for harvest of treatment-site tissues at days 3, 7, 14, 30, 60, and 90. Skin and muscle sections were examined microscopically and assigned a subjective score (0 to 4) for each of the following: overall severity of inflammation, fibrosis, number of macrophages, number of granulocytes, number of perivascular lymphocytes, and degree of suture fragmentation. Subjective score analysis revealed that CTA did not cause a significant inflammatory response, compared with the negative control. All suture materials caused significantly more inflammation over all time points; for all suture materials, inflammatory response scores were significantly higher than values for the negative control 90 days after implantation. No sutures were completely absorbed by the end of the study period, and several sutures appeared to be in the process of extrusion. In snakes, CTA can be used to close small superficial incisions or lacerations with minimal inflammatory response, and sutures may undergo extrusion from tissues prior to complete absorption.

Endoscope-assisted combined anterior and posterior procedures for spondylolisthesis

Objective To evaluate the clinical outcome of endoscope-assisted combined anterior and posterior procedures for grade-Ⅲ and Ⅳspondylolisthesis.Methods From December 2007 to May 2010,13 patients with grade-Ⅲ and Ⅳ spondylolisthesis were treated with two bilateral decompression,percutaneous pedicle screw restoration,intervertebral bone grafting and plate fixation using microendoscopic discectomy and laparoscopy,including 6 males and 7 females with an average age of 39.8 years (range,18-58 years).Eleven cases were in grade Ⅲ spondylolisthesis and two in Ⅳ.The lesion location was as follows:2 cases were at L4,5 and 11 at L5S1.The clinical outcomes were evaluated according to Oswestry disability questionnaire,and the change of radiographic data including slipping degree,slipping angle and posterior height of intervertebral disc.Results The mean follow-up time was 21 months (range,12-36 months).The mean operative time was 125 min,with a mean blood loss of 415 ml.Slipping degree decreased 56.9％ in average (from preoperative 73.3％±6.1％ to postoperative 16.4％±9.5％),slipping angle decreased 19.6°(from preoperative 27.7°±5.6° to postoperative 8.1°±8.8°),posterior height of intervertebral disc increased 7.1 mm (from preoperative 2.6 ±0.8 mm to postoperative 9.7 ±3.7 mm).The clinical outcomes of the Oswestry disability questionnaire decreased 19.5 (from preoperative 35.8±5.7 to postoperative 16.3±5.2).CT scans demonstrated that solid bony fusion could be obtained in one year after operation.Complications included dural sac tears in 1 case,and superficial incision infection in 1.The results were excellent in 4 cases,good in 8 and fair in 1.Conclusion Endoscope-assisted anterior and posterior procedures for grade-Ⅲ and Ⅳ spondylolisthesis is a reliable method,which can lead to rigid fixation and fusion,and also can achieve thorough decompression and restoration as much as possible. Key words: Laparoscopes; Spondylolisthesis; Treatment outcome

Plication corporoplasty versus Nesbit operation for the correction of congenital penile curvature. A long-term follow-up

Aim of the study is to evaluate the long-term results of tunica albuginea plication in patients with congenital curvature of the penis and to compare them with those obtained with the Nesbit technique. Overall, 62 patients underwent surgical correction of congenital curvature of the penis from 2003 to 2008 at our institution. Of these, only 31 consented to be reevaluated. Nineteen patients had plication corporoplasty by means of one or more double crossed introflecting stitches (group A) while 12 patients had a traditional Nesbit technique with excision of small parts of tunica albuginea (group B). All patients were reevaluated with physical examination, a specific questionnaire and self-photography on erection, after a mean follow-up of 38 months in group A and 40 months in group B. Student's t test was employed for statistical analyses. A total of 3 recurrences of curvature were observed in group A, 1-3 months after surgery, which required surgical correction. In all three patients, reabsorbable sutures had been employed for albuginea plication. No recurrences were observed in group B (P = 0.15). A minimal persistent deviation was present in 6 patients in group A (31%) and in 6 patients in group B (50%) (P = 0.29). A minimal hyposensitivity of glans and prepuce was reported in 7 patients in group A (38%) and in 9 patients in group B (75%) (P = 0.03). Plication corporoplasty yields good and stable results when compared to the Nesbit technique provided that unabsorbable sutures are used and superficial scalpel incision of the albuginea is performed.

Double tractors swing microendoscopic discectomy technique for multi-segmental lumbar disc herniation

Objective To evaluate the effect of double tractors swing microendoscopic discectomy technique in multi-segmental lumbar disc herniation. Methods From December 2006 to November 2009,153 patients with multi-segmental lumbar disc herniation were treated with double tractors swing microendoscopic discectomy. They included 85 cases of multi-segmental disc herniation, 53 cases of degenerative canal stenosis and 15 cases of lumbar instability. Among them, 2, 3, 4 and 5 fenestrations were performed in 105,33, 13 and 2 cases respectively and interbody fusion was done with ＂quanhe＂ inflation cage and screws in 15 cases. The results were evaluated with Macnab scale. Results All the 153 patients were followed from 3to 36 months, with an average of 16 months. The mean operative time was 45, 61, 83 and 110 min for 2,3,4 and 5 fenestrations respectively, with a mean blood loss of 150 ml. And it took extra 92 min to finish interbody fusion. Complications included dural sac tears in 1 case,canda equina slight lesion in 1, superficial incision infection in 1, the formation of deep venous thrombosis in 1, and revision for＂quanhe＂inflation cage in 1. The mean hospital stay was 10 days. Excellent results were obtained in 117 cases, good in 32 and fair in 4. One hundred and thirty-two patients returned to their work or normal activities in 3 weeks. One hundred and forty-nine cases were satisfied with the therapeutic effect. Conclusion This technique not only can reach adjacent intervertebral space easily but also disperse pressure on the nerve root effectively. This technique can provide thorough decompression and good results. Key words: Endoscopy; Lumbar vertebrae; Intervertebral disk displacemeut

O-010 Effective minimally invasive treatment of moderate lumbar spinal stenosis with the superion interspinous spacer

Introduction and purposeMild lumbar spinal stenosis (LSS) is treated with conservative measures although long term success remains elusive. Patients with severe radicular symptoms often require surgical intervention. However, there is...

Prevention is better than cure

“The more accurately to observe the progress of the infection, I selected a healthy boy about eight years old for the purpose of inoculation with the cowpox. The matter was taken from the suppurated sore on the hand of a dairy Maid who was infected by her master’s Cows, and it was inserted on the 14th May 1796 into the arms of the Boy by means of two superfi cial incisions each about three quarters of an inch long...During the whole of [the ninth day after this] he was perceptibly indisposed and had a restless night; but, on the following day he was perfectly well. On the 1st of July following this the Boy was inoculated with Matter immediately taken from a smallpox Pustule. Several punctures and slight incisions were made in both his arms, and the matter was well rubb’d into them, but no disease followed.”

Treatment of aseptic nonunion after intramedullary nailing fixation with locking plate

To evaluate the safety and efficacy of locking plate combined with bone grafting in the treatment of aseptic nonunion following intramedullary nailing fixation of fractures of the long bones. Thirty-eight consecutive patients treated in our hospital between January 2004 and December 2006 were included in this retrospective study. The nonunions included 20 femurs, 15 tibias, and 3 humeri. The duration of non-union ranged from 6 to 84 months and 21 (55.3%) of them were located around the metaphysis of the affected long bones. There were 12 women and 26 men with a mean age of 39.2 years (range, 9-70 years). Locking plate combined with bone grafting was the procedure chosen to treat every case of nonunion in this series. The clinical outcomes were evaluated. All patients were followed up for 6-20 months (average 11.6 months). After locking plate fixation combined with bone grafting, union was achieved in all cases, the average healing time being 5.3 months (range, 4-8 months). Infection of the superficial incision occurred in three cases (7.9%) and delayed healing of the incision in one case, all of which healed with no further complications. The function of the adjacent joints was excellent to good in 30 patients (78.9%), fair in 7 (18.4%) and poor in 1 (2.6%) after follow-up. Locking plate fixation combined with bone grafting is a highly effective treatment for aseptic nonunions of the long bones after intramedullary nailing fixation, especially in the case of metaphyseal nonunion.

Lamellar corneal injury by bamboo splinters: a case report

IntroductionWe report an unusual case of corneal lamellar injury caused by long bamboo splinters.Case presentationA 70-year-old Japanese man visited our hospital with a bamboo injury. Slit lamp examination revealed that a bundle of bamboo splinters had deeply penetrated the corneal stroma of the right eye from the nasal limbus. The splinters were approximately 8 mm in length, but had not perforated the anterior chamber. They were completely removed by superficial corneal incision alongside each splinter with no consequences. The eye has remained healed for 3 months postoperatively.ConclusionThe bamboo splinters did not perforate the anterior chamber, although they were long and hard enough to do so. This may be because the spatula-like shape and flexibility of the bamboo splinters allowed them to penetrate the lamellar layer of the corneal stroma with ease, but with no perforation of deeper tissue.

Infection after Elective Colorectal Surgery: Bacteriological Analysis of Failures in a Randomized Trial of Cefotetan vs. Ertapenem Prophylaxis

A randomized study comparing single-dose cefotetan and ertapenem prophylaxis for elective colorectal surgery in 1,002 patients found ertapenem to be significantly more effective (p < 0.001). Failures of prophylaxis were thought to involve organisms resistant to both antimicrobial agents, isolated most often from deep or superficial incision sites. Further testing and analysis of the microbial data was performed. Susceptibility results were correlated with the clinical outcomes reported previously. Of the 216 aerobes tested, 62.6% were resistant to cefotetan and 44% to ertapenem. Enterococci and methicillin-resistant Staphylococcus epidermidis were the aerobes recovered most frequently, and Bacteroides thetaiotaomicron, Clostridium innocuum, and Eubacterium lentum were the most frequent anaerobes. Enterococcus faecalis usually was associated in mixed culture with Bacteroides fragilis group species. Approximately one-half of the 158 anaerobes (50.7%), including all the species above, were resistant to cefotetan; most of these (61.4%) came from superficial incision sites. Only one anaerobe (Desulfovibrio fairfieldensis), found in a superficial incisional infection, was resistant to ertapenem, and no ertapenem-resistant enteric bacteria were recovered. In vitro resistance was associated with therapeutic failure. The in vitro activity of ertapenem was superior to that of cefotetan against all anaerobic and many aerobic bacteria isolated from postoperative cultures of patients who failed prophylaxis with these agents. Our findings help to elucidate the results of the clinical trial.

Mobile microendoscopic discectomy technique for lumbar disc herniation and canal stenosis.

Objective To develope a mobile mieroendoscopic discectomy (MED) technique, and e-valuate the clinical results of this technique for the treatment of lumbar disc herniation and canal stenosis. Methods 312 patients were treated with this technique in two hospitals for lumbar disc herniation and/or canal stenosis, these included disc herniation in 130 cases, disc herniation and lateral stenosis in 122 cases, degenerative canal stenosis in 60 cases. 26 of them had the history of surgical intervention at the same level. 212 patients were operated in Bagatelle hospital in France, followed a single level decompression. 100 pa-tients were operated in Tianjin hospital in China, including 1, 2, 3 and 4 fenestrations in 82, 14, 3 and 1eases, respectively, and interbody fusion was performed with B-Twin in 4 cases with instability. The patientswere followed from I to 24 months and the results were evaluated with Macnab scale. Results In Bagatellehospital, the mean operative time was 35 and 45 min for unilateral and bilateral decompression, respectively,with a mean blood loss of 35 ml, and only one complication of dural theca tear was encountered. The patients were discharged within 1-2d after operation without limitation of activity. The resuhs were excellent in 191eases, good in 15 cases and fair in 6 cases, and 200 patients recovered their work or normal activities in 3 weeks, in Tianjin hospital, the operative time was 50 min with a mean blood loss of 100 ml. Complicationsincluded conversion to open surgery in 2 cases, location errors in 4 cases, which were recognized intraopera-tively and immediately corrected, partial nerve root lesions in 2 eases, dural theca tears in 4 cases, and su-perficial incision infections in 2 case. The mean hospital stay was 5 d after operation. The results were excel-lent in 80 cases, good in 15 cases and fair in 5 cases, and 71 patients recovered their work or normal activi-ties in 3 weeks. Conclusion Compared to METRx system, the MED can be performed more easily with thorough decompression and provides good results for lumbar disc herniation and canal stenosis. Key words: Lumbar vertebrae; Intervertebral disk displacement; Spinal stenosis; Endoscopy

Bone damage induced by different cutting instruments: an in vitro study

The aim of this study was to compare the peripheral bone damage induced by different cutting systems. Four devices were tested: Er:YAG laser (2.94 mm), Piezosurgery, high-speed drill and low-speed drill. Forty-five bone sections, divided into 9 groups according to different parameters, were taken from pig mandibles within 1 h post mortem. Specimens were fixed in 10% buffered formalin, decalcified and cut in thin sections. Four different parameters were analyzed: cut precision, depth of incision, peripheral carbonization and presence of bone fragments. For statistical analysis, the Kruskal-Wallis test was applied to assess equality of sample medians among groups. All sections obtained with the Er:YAG laser showed poor peripheral carbonization. The edges of the incisions were always well-shaped and regular, no melting was observed. Piezosurgery specimens revealed superficial incisions without thermal damage but with irregular edges. The sections obtained by traditional drilling showed poor peripheral carbonization, especially if obtained at lower speed. There was statistically significant differences (p<0.01) among the cutting systems for all analyzed parameters. Er:YAG laser, gave poor peripheral carbonization, and may be considered an effective method in oral bone biopsies and permits to obtain clear and readable tissue specimens.

Postoperative Spinal Wound Infections

Surgical site infection is a common adverse event and a significant source of morbidity after any spinal procedure. A patient who presents with postoperative infection often requires prolonged hospitalization, revision surgical procedures, and long-term intravenous antibiotics. Awareness of risk factors and preventive measures can lead to improved outcomes. Infection after spinal surgery may pose diagnostic challenges and difficult management questions. Postoperative spinal infections present with a diverse degree of severity, from superficial skin incision infections to deep subfascial infections with myonecrosis. Definitive management is based on etiology, clinical course, and patient risk factors.

Messinian event in the black sea: Evidence of a Messinian erosional surface

In 1975, sediment cores from leg DSDP 42b (sites 380A and 381) revealed a thin sediment layer in the Black Sea basin which points to a shallow water environment at the Miocene-Pliocene boundary. With these facts and in the wake of hypothesis of the Messinian Salinity Crisis (MSC), it was proposed that the Black Sea, like the Mediterranean Sea, suffered a desiccation period at the end of the Messinian (Hsü, K.J. and Giovanoli, F., 1979. Messinian event in the Black Sea. Palaeogeography, Palaeoclimatology, Palaeoecology, 29: 75–93). Whereas the main topics of the MSC in the Mediterranean Sea is now widely accepted, the lack of evidence for a Messinian erosional surface in the Black Sea left the debate about the Messinian desiccation of this basin open until today. The analysis of high resolution multi-channel seismic data acquired during the BlaSON surveys brings important new elements for this scientific debate: (1) Down the slope offshore the Bosporus, we show a clear erosional surface correlated to the top of the Upper Miocene shallow water environment unit of site DSDP 381. The overlying Lower Zanclean unit inevitably dates this erosional surface of the Messinian event. (2) A wide intra-Pontian erosional surface (IPU) is evidenced on the Romanian shelf. The IPU is characterized by a sharp decrease in the incision rate from outer (deep canyons) to inner shelf (superficial incisions network). According to the most recent Paratethyan and Mediterranean stratigraphic scale correlations, the IPU erosional surface is considered as the analogue to the Messinian erosional surface described down the slope offshore the Bosporus. In addition to recently discovered inland erosional signature, the wide regional erosional surface we underline on the Western Black Sea margins validates the Black Sea Messinian desiccation hypothesis. We also demonstrate that evaporative draw-down of the Black Sea implied the installation in the basin of a negative hydrologic budget during the Messinian. The lack of a major Messinian Danube canyon on the Romanian shelf supports the hypothesis of a Messinian Danube trapped in the Dacic basin. However, the presence of a Messinian superficial incision network connecting the location of the modern Danube delta to deeply incised Messinian canyons on the outer shelf (IPU) makes the hypothesis of a Danube reaching the partially desiccated Black Sea still possible.

Wound infection after elective laparoscopic surgery for colorectal carcinoma

The aim of this study was to evaluate various clinical parameters that would influence the occurrence of wound infection (WI) in elective laparoscopic surgery (LS) for colorectal carcinoma. The study included 290 patients who underwent LS between June 2001 and December 2005. WI was diagnosed within 30 days of the operation, and both superficial and deep incision surgical site infection were evaluated together. Eighteen (6.2%) were diagnosed with WI. Of the infected patients, nine (50%) had WI at the extraction site, six (33%) at the port site of the drainage tube, and three (17%) at the supraumbilical incision. Following bivariate analysis, the variables of stoma creation, intraoperative hypotension, and length of operation were selected for multivariate analysis as their P values were <0.2, the predominant cutoff, and stoma creation and intraoperative hypotension were independently predictive of developing WI. Regarding the duration of postoperative hospital stay, there was no significant difference between patients with or without WI. Stoma creation and intraoperative hypotension were independent risk factors for WI. The results obtained in this study should be considered in an effort to prevent WI in LS for colorectal carcinoma, although these risk factors need further evaluation.

Extraperitoneal Laparoscopic Trigonoplasty for Treatment of Vesicoureteral Reflux: Novel Technique Duplicating its Open Counterpart

We describe a novel technique of extraperitoneal laparoscopic trigonoplasty for the treatment of vesicoureteral reflux. Three boys and 24 girls with 41 refluxing units underwent extraperitoneal laparoscopic trigonoplasty. A 10 mm incision was made below the umbilicus. With sharp, blunt finger dissection and balloon dilation an extraperitoneal space was created. The bladder was opened using a laparoscopic scissors. Two 3Fr ureteral catheters were inserted intracorporeally into the ureters. A transverse superficial incision was made in the epithelium between the ureteral orifices. The medial aspect of the ureters was cleared of the muscles and attachments, and sutured in the midline with 4-zero polyglactin sutures. Operative time ranged from 60 to 240 minutes (mean 147). Blood loss was less than 50 ml. Adequate extraperitoneal space, bladder opening, epithelial incision, ureteral approximation with secure suturing in the midline and bladder closure were carried out in all cases. Peritoneal perforation was noted in 4 patients while creating the extraperitoneal space, with suturing needed for 1 large perforation. Hospital stay was 1 to 6 days (mean 2.7). At 4 to 19 months of followup (mean 8.2) reflux had resolved in 38 units (93%). Extraperitoneal laparoscopic trigonoplasty is technically feasible. Results are comparable to open techniques. The major advantage of this procedure is the avoidance of peritoneum. Other advantages include a shorter hospital stay and good cosmesis. More followup is necessary to establish the long-term results.

Incidence of Surgical Site Infections in General Surgery in Italy

Epidemiological study to determine surgical site infection (SSI) rates in surgical patients in Italy using the National Nosocomial Infections Surveillance system (NNIS), to monitor current surgical antimicrobial prophylaxis, and to identify possible modifiable risk factors for SSI. Thirty-two general surgeries participated in the study. Main criteria for site inclusion were: > 20 operations per week and amoxycillin/clavulanate among prophylactic options. Each patient operated from April 1st to May 30th 2002 was surveyed until 30 days after the operation. SSI cumulative incidence rates and 95% confidence intervals (95%CI) were calculated. During the study period, 3,066 surgical procedures were performed in 2,972 patients. A total of 158 SSI were diagnosed in 154 patients: 96 (62.3%) were at superficial incision, 23 (14.9%) were at deep incision and 35 (22.7%) were at organ-space site. Incidence of SSI every 100 operations was 5.2% (95% CI 4.4-6.0). Of the 2,437 operated patients with clean or elective clean/contaminated or contaminated surgical procedure, 2,105 (86.4%) received antimicrobial prophylaxis, mainly amoxicillin/clavulanate (28.3%) and ceftizoxime (11.4%). Pre-operative hospital stay > or = 48 h, diabetes, obesity, and HIV/AIDS infection were statistically significantly associated with increased risk of SSI. The SSI rates found are comparable with European studies and can be a benchmark for national incidence data and for inter- and intra-hospital SSI rate comparisons.

Effect of Perioperative Nursing Intervention on the Outcomes of Amputation in Patients Diabetic Foot Gangrene

目的 探讨护理干预对糖尿病足坏疽(DIGF)截肢围手术期患者治疗转归的影响.方法20例因DIGF而接受截肢手术的患者进行围手术期护理干预:心理护理、血糖监测及控制、胰岛素用药护理、饮食护理、术后护理、功能锻炼.结果DIGF患者围手术期血糖控制良好,无死亡和低血糖休克发生,切口浅表感染2例,尿路感染1例.结论护理干预对促进DIGF截肢术后切口愈合和减少并发症发生有着非常重要的作用。

Les scarifications : le regard de la métamorphose

Scarifications are frequently seen in the passage from adolescence to adulthood. Their nosographic context has expanded to include defensive behavior in reaction to the difficulties of assuming autonomy, or those associated with separation, to an attempt to express acute anxiety in borderline states or in certain cases of psychosis. The transition to adulthood is a particularly exacting period for girls. In a society that places value upon visual appearance, the bodily changes that take place during puberty and the occurrence of the first menstruations are often a traumatic experience, and may temporarily inhibit the acceptance of womanhood. Self-mutilations constitute a corporal limit that may facilitate the adolescent's acceptance of the bodily change towards full femininity. As in the myth of Narcissus, scarifications or superficial cutaneous incisions are a means of providing the possibility of withdrawal into oneself; in an attempt to control underlying tension and anxiety the adolescent voluntarily causes blood to appear and disappear through self-mutilation, so that it is no longer perceived as a menace. Scarifications therefore allow girls an appropriation of the female body, and thus may be a means of their coming to terms with the metamorphosis that is taking place. This hypothesis has been illustrated through a specific case history.

Research on complications of thoracoscopic assisted thoracic spine surgery

To analyze occurrence, prevention and treatment of the complications of thoracoscopic assisted spine surgery. Retrospective review of 182 patients who underwent standard thoracoscopic technique or video-assisted thoracic surgical procedure from October 1998 to August 2004. The treatment of thoracic diseases included debridement, decompression with (or) reconstruction. The total number of complications were recorded, and its mechanism, prevention and treatment were analyzed. Complications occurred in 16 patients, 12 cases of perioperative complications included 3 patients suffered from pneumonia, 3 pulmonary atelectasis, 2 patients' lung injured by trocar, 1 patient obtained transient monoplegia, 2 suffered from transient intercostal nerve pain and 1 had superficial incision infection. Long-term complications occurred in 4 cases: spinal tuberculosis relapsed 2 cases (one who had diabetes obtained relapse in 8 months of post-operation and another relapsed with complex spinal tuberculosis in 4 weeks postoperation), 2 patients suffered from kyphosis deformity and pain. The type and incidence of complications with thoracoscopic spine surgery mainly depend on indication, operation procedures and anesthesia, only by limit surgical indication, ameliorate technique, obey surgical principle and consummate perioperative treatment can we obtain mini-invasive effect by thoracoscopic assisted spine surgery.