Frontiers in surgery · 2026
Application of the guidewire anchoring technique in lateral approach transforaminal endoscopic lumbar foraminoplasty: a propensity score-matched retrospective study.
Название и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ding G, Shang H, Yan F, Cui W, Li Z, Zhang Y, Wang Z, Feng Y, Su J, Zhang H
Аннотация
OBJECTIVE: Safe and rapid bony localization for intervertebral foraminoplasty is essential in lateral transforaminal endoscopic lumbar discectomy (TELD). This study introduces a novel guidewire anchoring puncture technique and compares it with conventional puncture to evaluate operative efficiency, safety, and clinical outcomes.
METHODS: A retrospective 1:1 propensity score-matched (PSM) analysis was performed on 60 patients with single-level L4/5 or L5/S1 disc herniation receiving TELD (anchoring group = 30, conventional group = 30). Baseline demographics, intraoperative metrics, neurological complications, and serial Oswestry Disability Index (ODI)/leg pain Numeric Rating Scale (NRS) scores (preoperatively, 1-day, 3-month, 12-month postoperatively) were compared. Post-hoc power calculation and linear mixed-effects models were applied for statistical validation.
RESULTS: Baseline characteristics were balanced after PSM (all standardized mean differences < 0.1). The anchoring group exhibited significantly shorter total operative time, superior articular process (SAP) foraminoplasty time, and fewer fluoroscopic exposures (all P < 0.001). Transient nerve irritation occurred in 3.3% (1/30) of anchoring patients versus 20.0% (6/30) of conventional patients; only one nerve injury (3.3%) appeared in the conventional group (Fisher's exact test P values provided). Intergroup NRS/ODI differences were non-significant at preoperative, 1-day, and 3-month timepoints (P > 0.05). Although the anchoring group had statistically lower 12-month NRS scores (P = 0.0027), the between-group difference failed to meet the established minimal clinically important difference (MCID) for leg pain.
CONCLUSION: The guidewire anchoring technique improves TELD foraminoplasty efficiency and reduces intraoperative radiation and neurological complication risk. However, given the single-center, small-sample, 12-month limited follow-up design, its broad clinical adoption requires further multicenter prospective validation. Both techniques deliver equivalent clinically meaningful long-term pain relief.
METHODS: A retrospective 1:1 propensity score-matched (PSM) analysis was performed on 60 patients with single-level L4/5 or L5/S1 disc herniation receiving TELD (anchoring group = 30, conventional group = 30). Baseline demographics, intraoperative metrics, neurological complications, and serial Oswestry Disability Index (ODI)/leg pain Numeric Rating Scale (NRS) scores (preoperatively, 1-day, 3-month, 12-month postoperatively) were compared. Post-hoc power calculation and linear mixed-effects models were applied for statistical validation.
RESULTS: Baseline characteristics were balanced after PSM (all standardized mean differences < 0.1). The anchoring group exhibited significantly shorter total operative time, superior articular process (SAP) foraminoplasty time, and fewer fluoroscopic exposures (all P < 0.001). Transient nerve irritation occurred in 3.3% (1/30) of anchoring patients versus 20.0% (6/30) of conventional patients; only one nerve injury (3.3%) appeared in the conventional group (Fisher's exact test P values provided). Intergroup NRS/ODI differences were non-significant at preoperative, 1-day, and 3-month timepoints (P > 0.05). Although the anchoring group had statistically lower 12-month NRS scores (P = 0.0027), the between-group difference failed to meet the established minimal clinically important difference (MCID) for leg pain.
CONCLUSION: The guidewire anchoring technique improves TELD foraminoplasty efficiency and reduces intraoperative radiation and neurological complication risk. However, given the single-center, small-sample, 12-month limited follow-up design, its broad clinical adoption requires further multicenter prospective validation. Both techniques deliver equivalent clinically meaningful long-term pain relief.