Objective To conduct a scoping review on the influencing factors of comorbid sleep disorders in adolescents with epilepsy, so as to provide a reference basis for clinical prevention and early intervention. MethodsFollowing the methodological framework of scoping review, relevant studies were systematically searched in PubMed, Web of Science, Cochrane Library, Embase, Chinese Biomedical Literature Database, CNKI, Wanfang, and VIP Database. The retrieval time limit was from the establishment of each database to April 30, 2025. The included literatures were summarized and analyzed. ResultsA total of 17 literatures were included, and 17 influencing factors related to comorbid sleep disorders in adolescents with epilepsy were identified, which were mainly divided into six categories: demographic factors, characteristics and severity of epilepsy, treatment-related factors, psychiatric comorbidities, organic neurological damage and neurocognitive development and psychosocial and environmental factors. ConclusionSleep disorders are relatively common in adolescents with epilepsy, and their influencing factors are multifaceted.There is a lack of large-sample research on this population in our country, especially the lack of discussion of the causal relationship between influencing factors and sleep disorders, resulting in a lack of basis for early intervention. Future research urgently needs to systematically identify key influencing factors and explore their internal mechanisms through large-sample surveys, so as to lay a solid scientific foundation for the construction of evidence-based intervention programs.
ObjectiveTo compare the effectiveness of robot-assisted (RA) minimally invasive surgery versus traditional fluoroscopy-assisted (FA) open posterior fixation surgery in treating thoracolumbar fractures with ankylosing spondylitis (AS). MethodsA clinical data of 21 cases of thoracolumbar fractures with AS who met the selection criteria between December 2016 and December 2023 was retrospectively analyzed. Ten cases underwent RA minimally invasive surgery group (RA group) and 11 cases underwent FA open posterior fixation surgery (FA group). There was no significant difference in gender, age, fracture segment distribution, fracture type, time from injury to surgery, visual analogue scale (VAS) score, and American Spinal Injury Association (ASIA) grading between RA group and FA group (P>0.05). The operation time, intraoperative blood loss, radiation exposure time, radiation dose, hospital stay, and complications of the two groups were recorded. According to Gertzbein-Robbins criteria, the accuracy of screw implantation was evaluated by CT within 1 week after surgery. During follow-up, pain and nerve function were evaluated by VAS score and ASIA grading. ResultsAll patients underwent surgery successfully, and there was no significant difference in operation time (P>0.05). The intraoperative blood loss and hospital stay in the RA group were significantly less than those in the FA group (P<0.05), and the radiation exposure time and radiation dose were significantly more than those in the FA group (P<0.05). A total of 249 pedicle screws were implanted in the two groups, including 118 in the RA group and 131 in the FA group. According to the Gertzbein-Robbins criteria, the proportion of clinically acceptable screws (grades A and B) in the RA group was significantly higher than that in the FA group (P<0.05). Patients in both groups were followed up 3-12 months, with an average of 6.8 months. The VAS scores of the two groups after surgery were significantly lower than those before surgery, and the differences were significant (P<0.05). The RA group had lower scores than the fluoroscopy group at 1 week and 3 months after surgery (P<0.05). There was no significant difference in neurological function grading between groups at 1 week and 3 months after surgery (P>0.05). In the FA group, 1 case of deep infection and 1 case of deep vein thrombosis of lower extremity occurred, while no complication occurred in the RA group, and there was no significant difference in the incidence of complications between groups (P>0.05). Conclusion Both RA minimally invasive surgery and FA open posterior fixation surgery can achieve good effectiveness. Compared with the latter, the former has more advantages in terms of intraoperative blood loss, hospital stay, and accuracy of pedicle screw insertion.