{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:39:54Z","timestamp":1791995994473,"version":"4.4.0"},"reference-count":61,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Lumbar spinal stenosis (LSS) is a common disease in the elderly, mostly due to degenerative changes in the lumbar spinal complex. Decompression surgery is the standard surgical treatment for LSS. Classically, total laminectomy\u2014which involves resection of the spinous process, entire laminae and medial facet\u2014has been the standard decompression technique; however, it can cause post-surgical instability. To overcome this disadvantage, various minimally invasive techniques that preserve the stabilization structures of the spine have been developed, and surgeons have begun to re-evaluate decompression surgery from the standpoint of reduced invasiveness and cost. More than two decades have passed since the introduction of microendoscopic spine surgery, and studies continue to shed light on its advantages and limitations as new knowledge becomes available. This article is a narrative review of the available literature, along with authors\u2019 experience, regarding the indications, surgical techniques, clinical outcomes, and limitations\/complications of microendoscopic decompression for LSS.<\/jats:p>","DOI":"10.3390\/medicina58030384","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:40:02Z","timestamp":1646599202000},"page":"384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Microendoscopic Lumbar Posterior Decompression Surgery for Lumbar Spinal Stenosis: Literature Review"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4800-9226","authenticated-orcid":false,"given":"Akinobu","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1007\/s00586-020-06339-1","article-title":"Prevalence of lumbar spinal stenosis in general and clinical populations: A systematic review and meta-analysis","volume":"29","author":"Jensen","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.maturitas.2020.05.018","article-title":"The World Health Organization (WHO) approach to healthy ageing","volume":"139","author":"Rudnicka","year":"2020","journal-title":"Maturitas"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1001\/jama.296.20.2441","article-title":"Surgical vs nonoperative treatment for lumbar disk herniation: The spine patient outcomes research trial (SPORT): A randomized trial","volume":"296","author":"Weinstein","year":"2006","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1056\/NEJMoa0707136","article-title":"Surgical versus nonsurgical therapy for lumbar spinal stenosis","volume":"358","author":"Weinstein","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1056\/NEJMoa070302","article-title":"Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis","volume":"356","author":"Weinstein","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e028743","DOI":"10.1136\/bmjopen-2018-028743","article-title":"Lumbar spine surgery across 15 years: Trends, complications and reoperations in a longitudinal observational study from Norway","volume":"9","author":"Grotle","year":"2019","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2707","DOI":"10.1097\/01.brs.0000248132.15231.fe","article-title":"United States\u2019 trends and regional variations in lumbar spine surgery: 1992\u20132003","volume":"31","author":"Weinstein","year":"2006","journal-title":"Spine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.wneu.2011.05.060","article-title":"Development of neurosurgery in germany: Comparison of data collected by polls for 1997, 2003, and 2008 among providers of neurosurgical care","volume":"77","author":"Steiger","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e009011","DOI":"10.1136\/bmjopen-2015-009011","article-title":"Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: A 15-year time-series study","volume":"5","author":"Sivasubramaniam","year":"2015","journal-title":"BMJ Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1055\/s-0029-1201407","article-title":"Ueber einklemmung bzw. Strangulation der Cauda equina","volume":"35","author":"Oppenheim","year":"1909","journal-title":"DMW-Dtsch. Med. Wochenschr."},{"key":"ref_11","first-page":"301","article-title":"Microendoscopic discectomy","volume":"3","author":"Foley","year":"1997","journal-title":"Tech. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1007\/s00586-014-3599-x","article-title":"Clinical outcomes after microendoscopic laminotomy for lumbar spinal stenosis: A 5-year follow-up study","volume":"24","author":"Minamide","year":"2014","journal-title":"Eur. Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1302\/0301-620X.100B4.BJJ-2017-0917.R1","article-title":"Minimally invasive spinal decompression for degenerative lumbar spondylolisthesis and stenosis maintains stability and may avoid the need for fusion","volume":"100-B","author":"Minamide","year":"2018","journal-title":"Bone Jt. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"132","DOI":"10.4184\/asj.2018.12.1.132","article-title":"Degenerative lumbar spondylolisthesis with spinal stenosis: A comparative study of 5-year outcomes following decompression with fusion and microendoscopic decompression","volume":"12","author":"Aihara","year":"2018","journal-title":"Asian Spine J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.1097\/BSD.0000000000000710","article-title":"Microendoscopic decompression for lumbar spinal stenosis with degenerative spondylolisthesis: The influence of spondylolisthesis stage (disc height and static and dynamic translation) on clinical outcomes","volume":"32","author":"Minamide","year":"2019","journal-title":"Clin. Spine Surg. A Spine Publ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1097\/BRS.0000000000003997","article-title":"Clinical outcomes of minimally invasive posterior decompression for lumbar spinal stenosis with degenerative spondylolisthesis","volume":"46","author":"Kobayashi","year":"2021","journal-title":"Spine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3171\/2020.8.SPINE201209","article-title":"Microendoscopic decompression for lumbar spinal stenosis caused by facet-joint cysts: A novel technique with a cyst-dyeing protocol and cohort comparison study","volume":"34","author":"Murata","year":"2021","journal-title":"J. Neurosurg. Spine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"664","DOI":"10.3171\/2013.8.SPINE13125","article-title":"Endoscope-assisted spinal decompression surgery for lumbar spinal stenosis","volume":"19","author":"Minamide","year":"2013","journal-title":"J. Neurosurg. Spine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1055\/s-0032-1319774","article-title":"Microendoscopic decompression surgery for lumbar spinal canal stenosis via the paramedian approach: Preliminary results","volume":"2","author":"Nomura","year":"2012","journal-title":"Glob. Spine J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"624","DOI":"10.3171\/spi.2005.2.5.0624","article-title":"Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis","volume":"2","author":"Ikuta","year":"2005","journal-title":"J. Neurosurg. Spine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.ocl.2007.02.006","article-title":"Minimally invasive operative management for lumbar spinal stenosis: Overview of early and long-term outcomes","volume":"38","author":"Asgarzadie","year":"2007","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"293","DOI":"10.3171\/2009.1.SPINE08288","article-title":"Postoperative outcome after modified unilateral-approach microendoscopic midline decompression for degenerative spinal stenosis","volume":"10","author":"Yagi","year":"2009","journal-title":"J. Neurosurg. Spine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1007\/s00586-013-2806-5","article-title":"Tubular surgery with the assistance of endoscopic surgery via midline approach for lumbar spinal canal stenosis: A technical note","volume":"22","author":"Mikami","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1097\/BSD.0b013e3182206dd3","article-title":"Efficacy of novel minimally invasive surgery using spinal microendoscope for treating extraforaminal stenosis at the lumbosacral junction","volume":"25","author":"Yamada","year":"2012","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"229","DOI":"10.22603\/ssrr.2018-0076","article-title":"Mid-term clinical results of microendoscopic decompression for lumbar foraminal stenosis","volume":"3","author":"Yoshimoto","year":"2019","journal-title":"Spine Surg. Relat. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/BSD.0b013e31828cff6e","article-title":"Microendoscopic lateral decompression for lumbar foraminal stenosis","volume":"27","author":"Enyo","year":"2014","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"789","DOI":"10.3171\/2020.5.SPINE20352","article-title":"Microendoscopic decompression for lumbosacral foraminal stenosis: A novel surgical strategy based on anatomical considerations using 3D image fusion with MRI\/CT","volume":"33","author":"Murata","year":"2020","journal-title":"J. Neurosurg. Spine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"342","DOI":"10.3171\/spi.2006.4.4.342","article-title":"Microendoscopic partial resection of the sacral ala to relieve extraforaminal entrapment of the L-5 spinal nerve at the lumbosacral tunnel","volume":"4","author":"Matsumoto","year":"2006","journal-title":"J. Neurosurg. Spine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1227\/01.NEU.0000156470.79032.7B","article-title":"Assessment of the learning curve for lumbar microendoscopic discectomy","volume":"56","author":"Nowitzke","year":"2005","journal-title":"Neurosurgery"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1055\/s-0036-1583943","article-title":"Assessment of the learning curve for microendoscopic decompression surgery for lumbar spinal canal stenosis through an analysis of 480 cases involving a single surgeon","volume":"7","author":"Nomura","year":"2017","journal-title":"Glob. Spine J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2002.13.2.6","article-title":"Bilateral decompressive surgery in lumbar spinal stenosis associated with spondylolisthesis: Unilateral approach and use of a microscope and tubular retractor system","volume":"13","author":"Palmer","year":"2002","journal-title":"Neurosurg. Focus"},{"key":"ref_32","first-page":"213","article-title":"Bilateral decompression of lumbar spinal stenosis involving a unilateral approach with microscope and tubular retractor system","volume":"97","author":"Palmer","year":"2002","journal-title":"J. Neurosurg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/00006123-200211002-00020","article-title":"Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis","volume":"51","author":"Khoo","year":"2002","journal-title":"Neurosurgery"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1227\/01.NEU.0000347007.95725.6F","article-title":"Midterm outcome after microendoscopic decompressive laminotomy for lumbar spinal stenosis","volume":"65","year":"2009","journal-title":"Neurosurgery"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e1219","DOI":"10.1016\/j.wneu.2020.11.131","article-title":"Long-term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: Minimum 10-year follow-up","volume":"146","author":"Aihara","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"431","DOI":"10.31616\/asj.2020.0120","article-title":"Long-term functional outcomes of endoscopic decompression with destandau technique for lumbar canal stenosis","volume":"15","author":"Gupta","year":"2021","journal-title":"Asian Spine J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1055\/s-0028-1082314","article-title":"Clinical outcome of microendoscopic posterior decompression for spinal stenosis associated with degenerative spondylolisthesis\u2013minimum 2-year outcome of 37 patients","volume":"51","author":"Ikuta","year":"2008","journal-title":"Min-Minim. Invasive Neurosurg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1302\/0301-620X.96B5.32957","article-title":"A prospective study of the incidence and outcomes of incidental dural tears in microendoscopic lumbar decompressive surgery","volume":"96-B","author":"Tsutsumimoto","year":"2014","journal-title":"Bone Jt. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1007\/s00586-009-0903-2","article-title":"Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis","volume":"18","author":"Pao","year":"2009","journal-title":"Eur. Spine J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.spinee.2019.04.015","article-title":"Influence of incidental dural tears and their primary microendoscopic repairs on surgical outcomes in patients undergoing microendoscopic lumbar surgery","volume":"19","author":"Soma","year":"2019","journal-title":"Spine J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2504","DOI":"10.1007\/s00586-016-4571-8","article-title":"The effect of incidental dural lesions on outcome after decompression surgery for lumbar spinal stenosis: Results of a multi-center study with 800 patients","volume":"26","author":"Kothe","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ulrich, N.H., On Behalf of the LSOS Study Group, Burgstaller, J.M., Brunner, F., Porchet, F., Farshad, M., Pichierri, G., Steurer, J., and Held, U. (2016). The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: Analysis of the Lumbar Spinal Outcome Study (LSOS) data\u2014A swiss prospective multi-center cohort study. BMC Musculoskelet. Disord., 17.","DOI":"10.1186\/s12891-016-1022-y"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1227\/01.neu.0000462078.58454.f4","article-title":"SPORT: Does incidental durotomy affect longterm outcomes in cases of spinal stenosis?","volume":"76","author":"Desai","year":"2011","journal-title":"Neurosurgery"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"E117","DOI":"10.1097\/BSD.0b013e31825bfdac","article-title":"Intraoperative myelography in minimally invasive decompression for degenerative lumbar spinal stenosis","volume":"25","author":"Pao","year":"2012","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3171\/spi.2006.5.5.404","article-title":"Evaluation of postoperative spinal epidural hematoma after microendoscopic posterior decompression for lumbar spinal stenosis: A clinical and magnetic resonance imaging study","volume":"5","author":"Ikuta","year":"2006","journal-title":"J. Neurosurg. Spine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2309499019869023","article-title":"Does the drain placement technique affect the amount of postoperative spinal epidural hematoma after microendoscopic decompressive laminotomy for lumbar spinal stenosis?","volume":"27","author":"Merter","year":"2019","journal-title":"J. Orthop. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1055\/s-2007-985152","article-title":"Surgical complications of microendoscopic procedures for lumbar spinal stenosis","volume":"50","author":"Ikuta","year":"2007","journal-title":"Min-Minim. Invasive Neurosurg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1097\/BRS.0b013e3181d82bb8","article-title":"Does minimal access tubular assisted spine surgery increase or decrease complications in spinal decompression or fusion?","volume":"35","author":"Fourney","year":"2010","journal-title":"Spine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1055\/s-2007-1022542","article-title":"Comparison of techniques for decompressive lumbar laminectomy: The minimally invasive versus the \u201cclassic\u201d open approach","volume":"51","author":"Rahman","year":"2008","journal-title":"Min-Minim. Invasive Neurosurg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.clineuro.2015.01.014","article-title":"Patient outcomes for a minimally invasive approach to treat lumbar spinal canal stenosis: Is microendoscopic or microscopic decompressive laminotomy the less invasive surgery?","volume":"131","author":"Fujimoto","year":"2015","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1055\/s-0037-1608871","article-title":"Short-term results of microendoscopic muscle-preserving interlaminar decompression versus spinal process splitting laminectomy","volume":"79","author":"Fukushi","year":"2018","journal-title":"J. Neurol. Surg. Part A Cent. Eur. Neurosurg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"252","DOI":"10.3892\/etm.2020.9382","article-title":"Clinical outcomes of MED and iLESSYS\u00ae delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis: A comparison study","volume":"20","author":"Wu","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"E3","DOI":"10.21037\/jss-20-620","article-title":"Comparative study between full-endoscopic laminectomy and microendoscopic laminectomy for the treatment of lumbar spinal canal stenosis","volume":"6","author":"Iwai","year":"2020","journal-title":"J. Spine Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e581","DOI":"10.1016\/j.wneu.2021.01.031","article-title":"Clinical comparison of unilateral biportal endoscopic laminectomy versus microendoscopic laminectomy for single-level laminectomy: A single-center, retrospective analysis","volume":"148","author":"Ito","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"E323","DOI":"10.1097\/BSD.0000000000001122","article-title":"Unilateral biportal endoscopy versus tubular microendoscopy in management of single level degenerative lumbar canal stenosis","volume":"34","author":"Aygun","year":"2021","journal-title":"Clin. Spine Surg. A Spine Publ."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jocn.2018.08.032","article-title":"Comparison of minimally invasive decompression and combined minimally invasive decompression and fusion in patients with degenerative spondylolisthesis with instability","volume":"57","author":"Hayashi","year":"2018","journal-title":"J. Clin. Neurosci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"E380","DOI":"10.1097\/BSD.0000000000000883","article-title":"Comparison of posterior lumbar interbody fusion and microendoscopic muscle-preserving interlaminar decompression for degenerative lumbar spondylolisthesis with >5-year follow-up","volume":"32","author":"Kimura","year":"2019","journal-title":"Clin. Spine Surg. A Spine Publ."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e17849","DOI":"10.1097\/MD.0000000000017849","article-title":"Decompression with fusion is not in superiority to decompression alone in lumbar stenosis based on randomized controlled trials","volume":"98","author":"Xu","year":"2019","journal-title":"Medicine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e165","DOI":"10.1016\/j.wneu.2017.12.009","article-title":"Decompression alone versus decompression and fusion for lumbar degenerative spondylolisthesis: A meta-analysis","volume":"111","author":"Chen","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/j.2757-7861.2008.00013.x","article-title":"The clinical features of, and microendoscopic decompression for, extraforaminal entrapment of the L5 spinal nerve","volume":"1","author":"Zhou","year":"2009","journal-title":"Orthop. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"72","DOI":"10.3171\/2009.7.SPINE09344","article-title":"Posterior decompression surgery for extraforaminal entrapment of the fifth lumbar spinal nerve at the lumbosacral junction","volume":"12","author":"Matsumoto","year":"2010","journal-title":"J. Neurosurg. Spine"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/3\/384\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:32:18Z","timestamp":1760135538000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/3\/384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":61,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["medicina58030384"],"URL":"https:\/\/doi.org\/10.3390\/medicina58030384","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]}}}