{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:12:57Z","timestamp":1782220377402,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T00:00:00Z","timestamp":1711843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Compared with traditional open surgery, percutaneous endoscopic lumbar discectomy (PELD) has the advantages of less trauma, faster recovery, and less postoperative pain, so it has been widely used in the field of spinal surgery. However, it still has the defect of intraoperative fluoroscopy occurrences, complications, and even the risk of damage to the spinal cord and nerve. This study aims to compare the clinical efficacy of modified percutaneous endoscopic interlaminar discectomy (MPEID) with percutaneous endoscopic transforaminal discectomy (PETD) in treating L4\/5 lumbar disc herniation (LDH) and to evaluate the effectiveness and safety of MPEID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010four L4\/5 LDH patients treated at the Second Affiliated Hospital of Nanchang University from June 2020 to June 2021 were studied retrospectively. Seventeen underwent MPEID and seventeen PETD. Variables analyzed included demographics, operative duration, intraoperative fluoroscopy occurrences, and surgical outcomes. Effectiveness was evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria. Lumbar Magnetic Resonance Imaging (MRI) was used to assess radiological outcomes. A paired <jats:italic>t<\/jats:italic>\u2010test was performed to compare intragroup pre\u2010 and postoperative clinical data, VAS, and ODI scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average operative time in PETD group was 91.65\u2009\u00b1\u200914.04\u2009min, and the average operative time in MPEID group was 65.41\u2009\u00b1\u200912.61\u2009min (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In PETD group, the fluoroscopy occurrences averaged 9.71\u2009\u00b1\u20091.05 times, with fluoroscopy occurrences averaging 6.47\u2009\u00b1\u20091.00 times (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in MPEID group. At 12\u2009months follow\u2010up, the clinical effect showed significant improvement in both two groups. The MPEID group showed a decrease in average VAS\u2010back score from 5.41\u2009\u00b1\u20092.18 to 1.76\u2009\u00b1\u20091.09 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and VAS\u2010leg score from 6.53\u2009\u00b1\u20091.66 to 0.82\u2009\u00b1\u20090.64 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The ODI scores decreased from 51.35\u2009\u00b1\u200910.65 to 11.71\u2009\u00b1\u20092.91 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the PETD group, the VAS\u2010back score decreased from 4.94\u2009\u00b1\u20091.98 to 2.06\u2009\u00b1\u20091.25 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), VAS\u2010leg score from 7.12\u2009\u00b1\u20091.73 to 1.12\u2009\u00b1\u20090.60 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and ODI scores from 48.00\u2009\u00b1\u200911.62 to 12.24\u2009\u00b1\u20092.56 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). According to the modified MacNab criteria, MPEID had 15 excellent and two good results; PETD had 12 excellent and 5 good (<jats:italic>p\u2009=\u20090.23<\/jats:italic>). No nerve root injuries, dural tears, or significant complications were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MPEID and PETD effectively treat L4\/5 LDH, with MPEID showing shorter operative times and fewer fluoroscopies. Furthermore, the MPEID group can provide excellent clinical efficacy as the PETD group in the short term.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14031","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T02:45:04Z","timestamp":1711939504000},"page":"1064-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near\u2010spinous Process Approach for <scp>L4<\/scp>\/5 Disc Herniation: A Retrospective Clinical Study"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9887-8257","authenticated-orcid":false,"given":"Peichuan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital of Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5180-8646","authenticated-orcid":false,"given":"Jinghong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics of Jiangxi Province  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-0563","authenticated-orcid":false,"given":"Tianlong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital of Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingwen","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital of Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital of Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6105-1499","authenticated-orcid":false,"given":"Xigao","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital of Nanchang University  Nanchang China"},{"name":"Institute of Orthopedics of Jiangxi Province  Nanchang 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