{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:38:14Z","timestamp":1761824294468,"version":"3.37.3"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81801320","Y20160329"],"award-info":[{"award-number":["81801320","Y20160329"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007194","name":"Wenzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["81801320","Y20160329"],"award-info":[{"award-number":["81801320","Y20160329"]}],"id":[{"id":"10.13039\/501100007194","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2021,1,19]]},"abstract":"<jats:p>Introduction. \u201cU\u201d route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of \u201cU\u201d route PELD on chronic pain patients with LSS combined with DH. Methods. Degenerative LSS combined with DH patients who underwent \u201cU\u201d route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results . All patients were of the age range from 47 to 85 years, with an average of 59.5\u2009\u00b1\u20099.76 years. Symptoms duration was 114.6\u2009\u00b1\u200922.77 months, operation time was 87.7\u2009\u00b1\u200925.20 minutes, and the average hospital stay was 5.8\u2009\u00b1\u20092.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), either low back and leg VAS or ODI decreased over time (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), and the excellent-to-good rate was improved from 88.75% to 93.42% during postoperative 2 years (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.05<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). Complications of dural tear, nerve root, or dysesthesia were reported in 5 patients, and all recovered after conservative therapy. The scores of pain catastrophizing were reduced after operation (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>&lt;<\/g:mo>\n                        <g:mn>0.001<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), but no significance of BDI was found between patients and healthy controls (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>&gt;<\/i:mo>\n                        <i:mn>0.05<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>). Conclusions. The \u201cU\u201d route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration.<\/jats:p>","DOI":"10.1155\/2021\/6657463","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T02:20:08Z","timestamp":1611109208000},"page":"1-9","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Outcomes of \u201cU\u201d Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-0992","authenticated-orcid":true,"given":"Binbin","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyi","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ce","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenchen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Center, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonghao","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4392-6888","authenticated-orcid":true,"given":"Danli","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China"},{"name":"Key Laboratory of Laboratory Medicine, Ministry of Education of China, Wenzhou 325035, Zhejiang, China"},{"name":"Wenzhou Key Laboratory of Sanitary Microbiology, Wenzhou 325035, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13212"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.11.001"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2016.08.007"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.11.011"},{"issue":"3","key":"5","first-page":"E419","article-title":"The role of the ligamentum flavum area as a morphological parameter of lumbar central spinal stenosis","volume":"20","author":"Y. 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