Objective To review the application status, clinical advantages, and complications of unilateral biportal endoscopy (UBE) technique and explore its future development direction. Methods By reviewing recent domestic and international literature, the evolution history of UBE technique, its surgical advantages, and its application effectiveness in various spinal diseases were analyzed, providing a comprehensive review. Results UBE technique, with its unique dual-channel design, provides a clearer surgical field and more flexible operating space, significantly reduces surgical trauma and postoperative recovery time. UBE technique has demonstrated high safety and effectiveness in the treatment of lumbar disc herniation, spinal stenosis, lumbar instability, and cervical spondylosis. Additionally, the complication incidence of UBE surgery is lower than that of traditional open surgery. Conclusion In recent years, UBE technique has shown good clinical application prospects and efficacy, but further technical optimization and large-scale clinical research are still needed to ensure the safety and effectiveness. In the future, the combination of UBE technique and intelligent medical and surgical robotics technology is expected to promote the further development of spinal surgery.
Objective To discuss the correlation between the letpin level and the pathogenesis of avascular necrosis of the femoral head (ANFH) by measuring the leptin expression of the femoral head in patients with ANFH. Methods Between July 2009 and February 2011, 16 patients with ANFH (including 10 cases of steroid-induced ANFH and 6 cases of alcohol-induced ANFH, ANFH group) and 11 patients with proximal femur fracture (control group) were included in the experiment. There was no significant difference in age, weight, and body mass index between 2 groups (P gt; 0.05). The peripheral blood and bone marrow were extracted to measure the blood lipid level and the free fat (FF) content, respectively. ELISA was used to detect the levels of the leptin, soluble leptin receptor (sLR), osteoprotegerin (OPG), and soluble receptor activator of nuclear factor κB (sRANKL); the leptin biological activity and the activity of osteoclasts were calculated. The femoral head specimens were harvested to count leptin-positive cells by immunohistochemical staining. Results No significant difference in the blood lipid level was found between 2 groups (P gt; 0.05), but the FF content in ANFH group was significantly lower than that in control group (t= — 14.230, P=0.000). The intramedullary leptin expression was found in both groups; however, the intramedullary leptin level in ANFH group decreased significantly when compared with the level in control group (t=4.425, P=0.002). There were significant differences in the levels of leptin, OPG, and sRANKL between 2 groups (P lt; 0.05). The leptin biological activity of ANFH group was significantly lower than that of control group (P lt; 0.05), but the activity of osteoclasts of ANFH group was significantly higher than that of control group (P lt; 0.05). There was a positive correlation between the leptin level and leptin biological activity (r=0.922 7, P=0.000 0), and a negative correlation between the leptin level and OPG content (r= — 0.396 2, P=0.040 8), FF content (r= — 0.806 1, P=0.000 0), while it had no correlation between the leptin level and sLR and sRANKL content (P gt; 0.05). Conclusion Intramedullary expression and bioactivity of the leptin decrease significantly in ANFH patients, which may play an important role in the pathogenesis of ANFH.