{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:22:16Z","timestamp":1792650136859,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81871124"],"award-info":[{"award-number":["81871124"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Conventional posterior\u2010approach decompression surgeries have a higher risk of nerve root injury and dura laceration. We explore the therapeutic strategy and effect of \u201cinside disc out\u201d discectomy under intervertebral foramen endoscope technique for discogenic lumbar spinal canal stenosis (DLSS) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010nine patients with DLSS in the responsible segment were treated with \u201cinside disc out\u201d discectomy under intervertebral foramen endoscope technique between October 2017 to October 2019. Lower limb and back pain were recorded before operation, and visual analogue scale (VAS) score and Oswestry disability index (ODI) were recorded for lower limb and back pain at 1, 3, 6, and 12\u00a0months postoperatively. The postoperative effects were evaluated using the modified MacNab method for all the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 29 patients successfully completed the operation. The operation time was 75\u2013120 min, with an average of 90\u2009\u00b1\u200917 min. Postoperative lumbar CT examinations of all the patients showed full decompression of the spinal cord with no residual pressure. The average follow\u2010up time for all the patients was 13\u2009\u00b1\u20093.5\u2009months (12\u201318\u00a0months). The VAS score for lower back and lower limb pain was 7.52\u2009\u00b1\u20091.25 before the operation, and 1.80\u2009\u00b1\u20090.63, 1.33\u2009\u00b1\u20090.88, 1.07\u2009\u00b1\u20090.89, and 0.81\u2009\u00b1\u20090.51 at 1, 3, 6, and 12\u00a0months after the surgery, respectively. The Oswestry dysfunction index was 59.43\u2009\u00b1\u200910.04 before surgery and 29.67\u2009\u00b1\u200910.35, 21.13\u2009\u00b1\u20099.32, 14.52\u2009\u00b1\u20095.98, and 9.84\u2009\u00b1\u20094.68 at 1, 3, 6, and 12\u00a0months after the surgery, respectively. The VAS score and ODI index of low back and lower limb pain at different time points after the surgery were significantly improved compared to those before the surgery (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). The effect of the modified MacNab was excellent in 26 patients, good in two patients, and fair in one patient. The excellent and good rates were 91.4%. Among them, one patient had symptoms of hyperesthesia in the anterior aspect of the thigh and decreased quadriceps muscle strength after lumbar 4\/5 segment endoscopic surgery. After symptomatic and conservative treatment, the symptoms disappeared 4\u2009weeks postoperatively, and there were no other serious surgical complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following the \u201cinside disc out\u201d discectomy under intervertebral foramen endoscope protocols, the risk of nerve injury can greatly be reduced, with good postoperative efficacy. Overall, the procedure is safe and feasible for DLSS treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13550","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T08:27:40Z","timestamp":1668760060000},"page":"355-361","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["\u201cInside Disc Out\u201d Discectomy for the Treatment of Discogenic Lumbar Spinal Canal Stenosis under the Intervertebral Foramen Endoscope"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9929-7558","authenticated-orcid":false,"given":"Shunqiang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Tianjin Medical University General Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tianjin Medical University General Hospital  Tianjin China"},{"name":"Department of Orthopaedic Surgery Cangzhou Central Hospital  Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4232-8146","authenticated-orcid":false,"given":"Yuan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tianjin Medical University General Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz161"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00064-016-0467-3"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04963-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001161"},{"key":"e_1_2_6_6_1","first-page":"324","article-title":"Comparative study of three minimally invasive surgical approaches for the treatment of L5\/S1 lumbar intervertebral disc herniation","volume":"31","author":"Wei H","year":"2021","journal-title":"Turk Neurosurg"},{"key":"e_1_2_6_7_1","volume":"27","author":"Yeung AT, Tsou PM.","journal-title":"Spine (Phila Pa 1976)"},{"key":"e_1_2_6_8_1","first-page":"49","article-title":"Percutaneous endoscopic lumbar discectomy: indications and complications","volume":"23","author":"Pan M","year":"2020","journal-title":"Pain Physician"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001122"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2020.03.08"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-3858-5"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2016.19.69"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-018-03685-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1155-x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1272-6"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13550","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T10:33:43Z","timestamp":1692441223000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,18]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/os.13550"],"URL":"https:\/\/doi.org\/10.1111\/os.13550","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,18]]},"assertion":[{"value":"2022-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}