{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:53:07Z","timestamp":1785775987460,"version":"3.56.0"},"reference-count":58,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100017686","name":"Fujian Provincial Health Technology Project","doi-asserted-by":"publisher","award":["2023GGA089"],"award-info":[{"award-number":["2023GGA089"]}],"id":[{"id":"10.13039\/501100017686","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Percutaneous endoscopic lumbar discectomy (PELD) is a preferred minimally invasive surgery for lumbar disc herniation (LDH); however, postoperative recurrence, nerve root damage, and hyperesthesia continue to present key clinical challenges. Chitosan represents a novel preventive approach against postoperative complications. This study aimed to assess the clinical efficacy of ultrasound\u2010guided percutaneous endoscopic interlaminar discectomy (PEID) plus medical chitosan in treating lumbar 4\u20135 disc herniation (L4\u20105 LDH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Totally, 200 L4\u20105 LDH patients were prospectively recruited and randomly divided into the control group (ultrasound\u2010guided PEID) and observation group (ultrasound\u2010guided PEID plus medical chitosan). Low back and leg pain and lumbar dysfunction were assessed preoperatively and postoperatively using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA). Efficacy and postoperative complications were evaluated according to the modified MacNab criteria. Logistic regression analyses identified the risk factors. Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test was used for inter\u2010group comparisons, and the Kruskal\u2013Wallis test for timepoint comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The two groups showed significant differences in pre\u2010treatment Pfirrmann classification and operation time. As time progressed, patients exhibited reduced VAS and ODI scores and increased JOA scores postoperatively. Significant differences were observed in VAS, JOA, and ODI scores in the observation group at 2\u2009weeks postoperatively. The observation group demonstrated superior treatment efficacy and a lower complication incidence than the control group. Age, disease course, and postoperative bleeding were independent risk factors affecting clinical efficacy of ultrasound\u2010guided PEID plus chitosan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasound\u2010guided PEID plus medical chitosan reduces postoperative pain and perioperative complications, demonstrating superior clinical efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70339","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:56:22Z","timestamp":1782183382000},"page":"1649-1659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Study of Ultrasound\u2010Guided Modified Percutaneous Endoscopic Interlaminar Discectomy Combined With Medical Chitosan in Lumbar 4\u20135 Disc Herniation Treatment"],"prefix":"10.1111","volume":"18","author":[{"given":"Liying","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pain The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurology The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8469-110X","authenticated-orcid":false,"given":"Binzhen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyun","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Second Hospital of Longyan  Longyan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178\u2010017\u20109441\u20104"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010015\u20100634\u20100"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13984"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010023\u201004361\u20109"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1298914"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.04.056"},{"issue":"1","key":"e_1_2_13_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_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701\u2010019\u201003876\u20107"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1004870"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000027412"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381\u2010013\u20102320\u20104"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010024\u201004543\u2010z"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010022\u201003282\u20103"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2024.08.011"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010024\u201008347\u2010x"},{"issue":"2","key":"e_1_2_13_17_1","first-page":"E105","article-title":"Unique Complications of Percutaneous Endoscopic Lumbar Discectomy and Percutaneous Endoscopic Interlaminar Discectomy","volume":"21","author":"Zhou C.","year":"2018","journal-title":"Pain Physician"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsami.4c11901"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cis.2023.103030"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/chem.202202156"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001\u2010025\u201002951\u20103"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsi.2022.08.030"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20235889"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000001133"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12698"},{"issue":"1","key":"e_1_2_13_26_1","first-page":"E45","article-title":"Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta\u2010Analysis","volume":"20","author":"Zhong M.","year":"2017","journal-title":"Pain Physician"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.05.061"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.14031"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010023\u201003824\u20103"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001810"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010024\u201004830\u20109"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201007695\u20102"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carbpol.2020.117108"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2022.10.090"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010023\u201005935\u20102"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.52965\/001c.138210"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12862"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002901"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics15030844"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010018\u20104156\u20108"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010024\u201005210\u2010z"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011940.pub2"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.916179"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010023\u201004485\u2010y"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1021\/bm100158p"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1039\/d1tb00948f"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871530320666200503054605"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmats.2022.994265"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000003193"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2019.00104"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13102\u2010023\u201000704\u20105"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010019\u20102975\u20104"},{"issue":"4","key":"e_1_2_13_53_1","first-page":"337","article-title":"Prevalence of Recurrent Herniation Following Percutaneous Endoscopic Lumbar Discectomy: A Meta\u2010Analysis","volume":"21","author":"Yin S.","year":"2018","journal-title":"Pain Physician"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201091964\u20103"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1049779"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2025.1598531"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S357033"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.14007"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.70152"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70339","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70339","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:26:12Z","timestamp":1785774372000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":58,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/os.70339"],"URL":"https:\/\/doi.org\/10.1111\/os.70339","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"2025-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}