文献类型：期刊文献

英文题名：Application of the guidewire anchoring technique in lateral approach transforaminal endoscopic lumbar foraminoplasty: a propensity score-matched retrospective study

作者：Ding, Guoxing[1,2];Shang, Huijing[2];Yan, Fuhai[1];Cui, Weijie[1];Li, Zhi[1];Zhang, Yiheng[1];Wang, Zhan[3];Feng, Yifan[4];Su, Junxiao[5];Zhang, Hui[3]

第一作者：Ding, Guoxing

通信作者：Zhang, H[1]

机构：[1]Gansu Univ Tradit Chinese Med, Clin Med Coll 1, Lanzhou, Gansu, Peoples R China;[2]Liangzhou Hosp, Dept Pain Med, Wuwei, Gansu, Peoples R China;[3]Gansu Prov Peoples Hosp, Dept Spine Surg, Lanzhou, Gansu, Peoples R China;[4]Mudanjiang Med Univ, Coll Basic Med, Heilongjiang, Peoples R China;[5]Tsinghua Univ, Dept Orthoped, Affiliated Hosp 1, Beijing, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Peoples Hosp, Dept Spine Surg, Lanzhou, Gansu, Peoples R China.

年份：2026

卷号：13

外文期刊名：FRONTIERS IN SURGERY

收录：;Scopus(收录号：2-s2.0-105050251739);WOS:【SCI-EXPANDED(收录号:WOS:001871331400001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. Hospital Research Fund of Gansu Provincial People's Hospital in 2024 (No.: 24GSSYH-6). The Gansu United Research and Development Program [Grant Number 25JRRA1205]. The Gansu Natural Science Foundation [Grant Number 24JRRA1058].

语种：英文

外文关键词：anchoring guidewire technique; foraminoplasty; lumbar disc herniation; percutaneous endoscopic lumbar discectomy; superior articular process

摘要：Objective Safe and rapid bony localization for intervertebral foraminoplasty is essential in lateral transforaminal endoscopic lumbar discectomy (TELD). This study introduces a novel guidewire anchoring puncture technique and compares it with conventional puncture to evaluate operative efficiency, safety, and clinical outcomes. Methods A retrospective 1:1 propensity score-matched (PSM) analysis was performed on 60 patients with single-level L4/5 or L5/S1 disc herniation receiving TELD (anchoring group = 30, conventional group = 30). Baseline demographics, intraoperative metrics, neurological complications, and serial Oswestry Disability Index (ODI)/leg pain Numeric Rating Scale (NRS) scores (preoperatively, 1-day, 3-month, 12-month postoperatively) were compared. Post-hoc power calculation and linear mixed-effects models were applied for statistical validation. Results Baseline characteristics were balanced after PSM (all standardized mean differences < 0.1). The anchoring group exhibited significantly shorter total operative time, superior articular process (SAP) foraminoplasty time, and fewer fluoroscopic exposures (all P < 0.001). Transient nerve irritation occurred in 3.3% (1/30) of anchoring patients versus 20.0% (6/30) of conventional patients; only one nerve injury (3.3%) appeared in the conventional group (Fisher's exact test P values provided). Intergroup NRS/ODI differences were non-significant at preoperative, 1-day, and 3-month timepoints (P > 0.05). Although the anchoring group had statistically lower 12-month NRS scores (P = 0.0027), the between-group difference failed to meet the established minimal clinically important difference (MCID) for leg pain. Conclusion The guidewire anchoring technique improves TELD foraminoplasty efficiency and reduces intraoperative radiation and neurological complication risk. However, given the single-center, small-sample, 12-month limited follow-up design, its broad clinical adoption requires further multicenter prospective validation. Both techniques deliver equivalent clinically meaningful long-term pain relief.