Objective  To discuss the clinical efficacy of anterior debridement，allografting and titanium plate instrumentation for lower cervical spondylodiscitis.Methods  57 patients with lower cervical spondylodiscitis treated by anterior debridement，allografting and titanium plate instrumentation in our hospital from April 2011 to June 2015，including 36 cases of tuberculosis (A group)，13 cases of brucellosis (group B)，8 cases of pyogenic infections (group C).There were 32 males and 25 females，with a mean age of (53.1±7.95) years.All of the patients were followed-up at least 12 months.Now we retrospectively analyzed the collected clinical data.Clinical features of 3 kinds of cervical spondylodiscitis were discussed according to clinical manifestations，laboratory and imaging findings.Efficacy of surgery was evaluated using pre-operative and last follow-up neck pain VAS score，JOA score，Frankel grade and Cobb angle，and allogeneic bone fusion was evaluated according to Bridwell standard as well.Results  All patients were successfully operated without the surgical related complications like spinal cord，nerve，blood vessel damage.The mean operative time was (102.5±28.8)min，mean blood loss was (112.2±48.7) mL，the average follow-up period was (22.7±8.1) months.At last follow-up，neck pain VAS score improved from preoperative (6.43±1.64) to (0.81±0.74)，with a improvement rate of 87.4％.Cervical JOA score improvement was excellent in 42 cases (73.7％)，good in 11 cases (19.3％)，3 cases (5.2％)，and poor in 1 (1.8％)，showing a fine rate of 93％.52 cases of fusion reached level Ⅰ according to the Bridwell fusion standard，the total effective fusion rate was 91％；Frankle grade showed that 34 cases (59.6％) combined with neurological dysfunction preoperative，including 23 cases (63.9％) in group A，6 cases (46.2％) in group B，5 cases (62.5％) in group C，at the last follow-up except 3 cases` Frankle grade improved to grade D，the other patients were back to normal.3 cases of tuberculosis group were re-operated，2 cases were due to pseudarthrosis，1 patient was due to kyphosis related neurological disorders.During the follow-up period，no one patient occurred wound infection，internal fixation or allogenic bone graft prolapse and recurrence.Conclusion  For tuberculous，brucellar and pyogenic lower cervical spondylodiscitis，anterior surgery can obtain complete debridement and spinal cord decompression.The application of allogeneic bone graft and titanium plate is safe and reliable，and can improve the clinical efficacy.

Objective  To explore the efficacy and safety of bilateral transforaminal thoracolumbar interbody fusion (bilateral TTIF) to treat giant central TLDH.Methods  Twenty consecutive patients with giant central TLDH underwent bilateral TTIF from January 2014 to June 2015 and were followed for 12 months.Clinical and radiological data were prospectively examined，including operative time，blood loss，pre-and postoperative American Spinal Injury Association (ASIA) score for sensory and motor function，visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores，fusion rate，extent of decompression，rate of instrumentation failure，and complications.Results  The average time of surgery was (155±27)min，and blood loss was (824±162)mL.The ASIA sensory and motor scores improved from (72.88±3.26) to (90.34±2.74) and from (67.52±4.2)to (88.3±3.1)，respectively.VAS for back pain and ODI decreased from (6.78±1.99) to (2.34±0.46) and from (44.82±5.18)％ to (11.7±2.4)％，respectively.Canal encroachment improved from (51.3±5.6)％ to (2±0.5)％ at the last follow-up.Surgery complications were seen in 5 patients (25％)，who experienced intraoperative dural tear and cerebrospinal fluid leak.There were no other major complications at last follow-up.Conclusion  Bilateral TTIF produced satisfactory outcomes and may be one of the surgical treatments of choice for myelopathy due to giant central TLDH.

Objective  To establish vertebrolplasty animal model to observe the effects of Vertebroplasty to adjacent intervertebral disc(IVD) degeneration.Methods  12 healthy mature New Zealand Rabbits were chosen.For every rabbit L_4～5and L_5～6 were treated as operative IVD (OPD)；L_3～4and L_6～7were treated as sham-operative IVD (SOPD)；L_2～3and L7/S1 were treated as control IVD (CD).X-ray and MRI examinations were taken for each rabbit before the surgery，right after the surgery，12 weeks and 24 weeks later.We euthanized 6 rabbits at 12 weeks and another 6 rabbits at 24 weeks postoperative，took histopathology test (HE stain)，determined the content of Glycuronic acid in nucleus pulposus with Sulfuric Acid Carbazole.Results  MRI examination results：The nucleus pulposus area signals of 12 weeks postoperative for OPD，SOPD and CD were no significant changes compared with signals of the preoperative image.The nucleus pulposus area signals of 24 weeks postoperative for OPD，Sham-OPD and CD were same too.Organization morphological results (HE staining)：The HE staining slice of OPD，SOPD and CD did not show signs of intervertebral disc degeneration at 12 weeks or 24 weeks later.12 and 24 weeks after the surgery，the Glycuronic acid content of OPD，SOPD respectively compared with the control disc.The difference there were no significant(P＞0.05).Conclusion  In the experiment VP animal model was established successfully.In this animal model，no significant sign of degeneration was observed in adjacent IVD.