{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:53:31Z","timestamp":1790913211760,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82572812"],"award-info":[{"award-number":["82572812"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2026QC1745"],"award-info":[{"award-number":["ZR2026QC1745"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Large annular defects after lumbar discectomy remain a major risk factor for recurrent herniation, particularly when the annular tear is located adjacent to the bony endplate, for which no well\u2010established endoscopic repair strategy is currently available. To evaluate the feasibility and early clinical outcomes of a novel endoscopic annular\u2010repair technique using an all\u2010suture anchor implanted into the superior surface of the inferior vertebral endplate, performed entirely through unilateral biportal endoscopy (UBE), for closure of large annular defects near the endplate after lumbar discectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a novel annular repair technique performed entirely under UBE using an all\u2010suture anchor implanted into the superior surface of the inferior vertebral endplate, which is particularly suitable for lumbar disc herniation (LDH) cases involving downward migration of disc fragments. A monofilament shuttle is advanced across the annular tear, enabling passage of high\u2010strength sutures that approximate the torn annulus to bone. We developed a bone\u2010to\u2010annulus repair method in which a monofilament shuttle is passed across the annular tear under direct UBE visualization to deliver high\u2010strength braided sutures through the defect; these sutures are then secured to an all\u2010suture anchor placed in the endplate, tension\u2010tested, and the knot buried within the annulus. The technique was applied in a preliminary consecutive series of five patients presenting with 5\u20136\u2009mm full\u2010thickness annular defects discovered intraoperatively during UBE discectomy. Procedural time, intraoperative complications, and early clinical and radiographic outcomes were recorded, follow\u2010up included one\u2010month clinical assessment and imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The annular repair was technically feasible in all five cases, with the repair step adding a mean of 16\u2009min to the standard discectomy. There were no intraoperative complications related to anchor placement or suture passage. All patients reported rapid relief of radicular symptoms and were mobilized early postoperatively. At one\u2010month follow\u2010up, clinical examination and imaging demonstrated intact annular repairs with no evidence of recurrent herniation or implant migration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The described UBE all\u2010suture anchor technique enables direct bone\u2010to\u2010annulus fixation and safe closure of moderate (5\u20136\u2009mm) full\u2010thickness annular defects through standard endoscopic portals. Early results indicate technical feasibility, safety, and promising short\u2010term clinical outcomes. Further biomechanical validation and longer\u2010term, larger\u2010cohort studies are required to determine its effectiveness in reducing recurrent LDH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70415","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:44:36Z","timestamp":1788313476000},"page":"2230-2237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Annular Repair Using an All\u2010Suture Anchor Under Unilateral Biportal Endoscopy: Technical Note and Case Series"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-6819","authenticated-orcid":false,"given":"Pengzhi","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiarui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuexiao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5123-9877","authenticated-orcid":false,"given":"Hongfei","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010024\u201008528\u20108"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010025\u201006024\u20103"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.36809"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2016.03.005"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.07.214"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.7.FOCUS15281"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wnsx.2024.100275"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002501"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632\u2010200009010\u201000004"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31828b2e2f"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering9020047"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181e08f01"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm\u201020\u20102257"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2023.03.011"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2021.12.015"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u2010D\u201020\u201001224"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/ten.TEB.2017.0351"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010015\u20104316\u20100"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010024\u201004725\u20109"},{"key":"e_1_2_12_21_1","first-page":"E713","article-title":"Microendoscopic 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