{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:07:17Z","timestamp":1772827637133,"version":"3.50.1"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,17]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Endoscopic management of L4\u20135 rostrally migrated lumbar disc herniation (LDH) poses technical challenges. The aim of this study was to compare the clinical outcomes and safety profiles of percutaneous endoscopic transforaminal discectomy (PETD), percutaneous endoscopic interlaminar discectomy (PEID), and unilateral biportal endoscopic discectomy (UBED) for treating this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective analysis of 81 patients who underwent PETD (n = 19), PEID (n = 36), or UBED (n = 26) from April 2019 to October 2022 at a single center was conducted. Over a 24-month follow-up, clinical evaluations included the visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores, as well as the modified MacNab criteria. Surgical parameters, facet joint integrity, and paraspinal muscle loss were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>All three groups demonstrated significant postoperative improvement in VAS (low back pain and leg pain), ODI, and JOA scores. The UBED group had higher VAS scores for incision pain compared with the other two groups. Within 1 week after the procedure, both the PEID and UBED groups had lower VAS scores for leg pain and higher JOA scores. Notably, the PEID group exhibited the lowest ODI at the 1-week follow-up. At the final follow-up, no significant differences were observed in VAS, ODI, and JOA scores among these groups. No significant differences were observed in modified MacNab evaluation, complication rates, recurrence rates, or the loss ratio of paraspinal muscles. However, PEID and PETD demonstrated advantages in operative time, total incision length, intraoperative blood loss, fluoroscopy injection time, duration of the postoperative hospital stay, total hospitalization expenditure, and serum C-reactive protein and creatine phosphokinase levels. PEID showed optimal performance in preserving the integrity of L4\u20135 facet joints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>PETD, PEID, and UBED demonstrated comparable and satisfactory long-term efficacy in treating rostrally migrated L4\u20135 LDH over a 2-year follow-up period. PEID emerged as the preferred approach for early postoperative recovery, offering superior preservation of L4\u20135 facet joint integrity and reduced surgical invasiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.spine25378","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:53:20Z","timestamp":1763412800000},"page":"108-117","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of effect and complication among three different spinal endoscopic procedures for L4\u20135 rostrally migrated lumbar disc herniations: a 2-year retrospective cohort study"],"prefix":"10.3171","volume":"44","author":[{"given":"Ziwei","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingjun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhe","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiumin","family":"Deng","sequence":"additional","affiliation":[{"name":"National Center for Liver Cancer Research and Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Teng","sequence":"additional","affiliation":[{"name":"Renji College, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengxian","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honglin","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"BMC Musculoskelet Disord","first-page":"722","article-title":"Unilateral biportal endoscopic discectomy via translaminar approach for highly upward-migrated lumbar disc herniation: a technical note and preliminary treatment outcomes","volume":"25","author":"Chen WC","year":"2024","unstructured":"Chen WC, Wang WT, Pao JL. Unilateral biportal endoscopic discectomy via translaminar approach for highly upward-migrated lumbar disc herniation: a technical note and preliminary treatment outcomes. BMC Musculoskelet Disord. 2024;25(1):722."},{"issue":"3-4","key":"b2","series-title":"Acta Neurochir (Wien)","first-page":"143","article-title":"Are there typical localisations of lumbar disc herniations? A prospective study","volume":"117","author":"Ebeling U","year":"1992","unstructured":"Ebeling U, Reulen HJ. Are there typical localisations of lumbar disc herniations? A prospective study. Acta Neurochir (Wien). 1992;117(3-4):143\u2013148."},{"issue":"4","key":"b3","series-title":"Asian J Endosc Surg","first-page":"200","article-title":"Percutaneous endoscopic translaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine","volume":"5","author":"Dezawa A","year":"2012","unstructured":"Dezawa A, Mikami H, Sairyo K. Percutaneous endoscopic translaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine. Asian J Endosc Surg. 2012;5(4):200\u2013203."},{"issue":"5","key":"b4","series-title":"J Bone Joint Surg Am","first-page":"891","article-title":"Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients","volume":"53","author":"Macnab I","year":"1971","unstructured":"Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. 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