Noah Willett, Chibuikem A. Ikwuegbuenyi, Evan Wang, Lawrance K. Chung, Anthony Robayo, Albert Antar, Galal Elsayed, Gianluca Vadalà, Ibrahim Hussain, Roger Härtl, AO Spine Knowledge Forum Degenerative
Neurospine 2026;23(1):117-144. Published online January 31, 2026
To address disc reherniation, several annular repair strategies have been developed, including implantable devices, suture-based techniques, and biomaterials. This review evaluates the clinical evidence supporting these strategies. A systematic search of PubMed, Cochrane, and Embase and MEDLINE via Ovid was performed from database inception to July 2025. A combination of keywords was used in the search string. Publications were included if they were clinical studies and described closing the annulus or blocking the annulus defect with biologics, sutures, or physical devices. Exclusion criteria were animal studies, in vitro studies, non-English articles, and abstracts. A single-arm proportional meta-analysis was performed for studies reporting extractable reherniation, reoperation, or complication data. The initial search identified 1,349 records. After removal of 315 duplicates, 1,034 studies underwent screening, with 84 full texts reviewed and 62 meeting inclusion criteria. Forty-one studies (66%) assessed implantable physical devices, of which 40 (98%) evaluated the Barricaid annular closure device (ACD) (Intrinsic Therapeutics, Inc., USA). Eighteen studies (29%) evaluated suture-based closure of the annulus fibrosus, using preloaded devices, bone-anchored systems, or manual suturing techniques. Three studies (5%) examined the use of biomaterials as either an adjunct or standalone method in the form of autologous conditioned plasma, bone marrow stromal cells, and fibrin sealant. For physical devices, the pooled reherniation, reoperation, and complication rates were 4.71%, 4.84%, and 1.76% respectively. Suture-based techniques had reherniation, reoperation, and complication rates of 1.37%, 0.35%, and 0.28%, respectively. For biomaterial-based approaches, only a pooled reherniation rate was calculated (2.11%), as insufficient data were available to pool reoperation and complication rates. Annular repair following discectomy is associated with low rates of reherniation, reoperation, and complications across physical devices, suture-based techniques, and biomaterial approaches. Physical devices and suturing techniques have robust clinical evidence and show generally favorable outcomes, but results remain mixed and heterogenous across techniques. Biomaterials demonstrate early promise but are limited by small study size and short follow-up. While pooled proportional meta-analysis supports the overall safety and effectiveness of annular repair, heterogeneity and limited comparative evidence prevent determination of relative superiority.
Luca Ambrosio, Jordy Schol, Stone Sima, Clara Ruiz-Fernandez, Victor Chen, Fabrizio Russo, In-Ho Han, Daisuke Sakai, Gianluca Vadalà, Vincenzo Denaro, Ashish D. Diwan, AO Spine Knowledge Forum Degenerative
Neurospine 2026;23(1):3-28. Published online January 31, 2026
Lumbar disc herniation (LDH) is one of the most common causes of low back and leg pain. While mechanical and degenerative factors have long been considered the main contributors, persistent or recurrent symptoms in many patients suggest additional biological mechanisms. Recent research has highlighted the microbiome as a potential modulator of inflammation, immune response, and pain sensitization, introducing the “gut-spine axis” concept. This scoping review summarizes the current evidence on the role of both gut and local disc microbiota in LDH. A systematic search of PubMed/MEDLINE and Scopus was conducted up to June 2025, following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Twenty-six studies were included, encompassing preclinical and clinical investigations. Animal models showed that LDH may alter gut microbial composition and that microbiome-targeted interventions can reduce inflammation, neuroinflammatory signaling, and pain sensitivity. In human studies, low-virulence bacteria, particularly Cutibacterium acnes, were frequently detected in surgically excised intervertebral discs, although results were inconsistent due to methodological heterogeneity and potential contamination. Some studies reported associations between bacterial colonization and Modic changes, disc height loss, or chronic pain. Additionally, genetic and metabolomic data suggest that gut dysbiosis and related microbial metabolites may influence systemic immune and metabolic pathways implicated in disc degeneration and pain perception. Overall, the current evidence suggests the biological plausibility of microbiome involvement in LDH pathophysiology, acting through both systemic and local mechanisms. However, the available data remain preliminary, and no mechanistic study has confirmed the observed correlations to date. Further standardized, contamination-aware studies are required to clarify causality and explore microbiome-targeted therapeutic strategies.
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Patients With Chronic Low Back Pain Without Advanced Disk Degeneration Exhibit Gut Microbiome Dysbiosis: Evidence From an Age‐, Sex‐, and BMI‐Matched Pilot Study Stone Sima, Thomas Jeffries, Alisha Sial, Suhani Sharma, Neha Chopra, Fan Zhang, Georgina Hold, Wentian Li, Ji Tu, Victor Chen, Ashish Diwan JOR SPINE.2026;[Epub] CrossRef
Conservative Treatment of Lumbosacral Intervertebral Disc Herniations: A Review of Current Approaches Kirill M. Kasatkin Medicine and Biotechnology.2026; 2(2): 124. CrossRef
Lost in Translation: Why Biologic Therapies for Intervertebral Disc Degeneration and Low Back Pain Have Not Reached the Clinic (Yet) Luca Ambrosio, Jordy Schol, Clara Ruiz‐Fernandez, Vincenzo Denaro, Gianluca Vadalà, Daisuke Sakai JOR SPINE.2026;[Epub] CrossRef
Biomarkers are becoming pivotal in understanding the complex pathophysiology of disc herniation and guiding novel therapeutic strategies. Recent research highlights the value of molecular and cellular biomarkers in delineating disease progression, treatment monitoring and patient stratification. This review summarizes current advances in the identification and validation of emerging biomarkers across genomic, transcriptomic, proteomic, and metabolomic domains, emphasizing their potential to bridge basic mechanistic insights with clinical translation. Particular attention is given to the interplay between inflammatory mediators, extracellular matrix turnover, and immune cell activity as indicators of lumbar disc herniation diagnosis and prognosis. Despite encouraging progress, standardization of biomarker validation protocols, inter-study comparability, and large-scale clinical implementation remain major challenges. Future directions include the integration of multi-omics technologies and bioinformatic tools to identify predictive biomarker panels with diagnostic and prognostic utility towards personalized medicine.
Low back pain is a leading cause of disability worldwide, with intervertebral disc herniation contributing substantially to its burden. Most patients improve with conservative care, often associated with disc resorption. Although increasingly recognized as a major determinant of recovery, the mechanisms underlying resorption remain poorly understood. Herniated disc tissue induces immune cell infiltration and release of cytokines and proteolytic enzymes, yet standard anti-inflammatory treatments may paradoxically impede this process. Outcomes are also influenced by physical therapy, lifestyle, herniation characteristics, and immunological background, but predictive biomarkers are lacking. This review summarizes the current knowledge gap and explores strategies to harness intrinsic healing for personalized management.
Objective This systematic review and meta-analysis aimed to compare endoscopic discectomy (ED) with microdiscectomy (MD) for lumbar disc herniation, evaluating patient-reported outcomes, perioperative parameters, and complications to determine if ED could replace MD as the gold standard.
Methods Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, we searched PubMed, Embase, Scopus, and Web of Science (January 2000–June 2025) for randomized controlled trials (RCTs) and prospective cohort studies comparing MD with ED subtypes (transforaminal endoscopic lumbar discectomy [TELD], interlaminar endoscopic lumbar discectomy [IELD], and unilateral biportal endoscopy [UBE]). Outcomes included Oswestry Disability Index (ODI), visual analogue scale (VAS) for pain, operative time, hospital stay, complications, and recurrence. Pooled mean differences and odds ratios (ORs) were calculated using random-effects models, with subgroup analyses by ED subtype. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools.
Results Seventeen studies (9 RCTs, 8 cohorts; n=3,115) were included. ED significantly reduced hospital stay (mean difference, -2.43 days; 95% CI, -3.62 to -1.23; p<0.05) and showed greater short-term ODI improvement (mean difference, 2.13; 95% CI, 0.58–3.67). No differences were observed in operative time, long-term ODI, or VAS scores. ED had lower wound complications but a higher recurrence risk with TELD (OR, ~2.0). High heterogeneity (I²>95%) and limited long-term data (>2 years) were noted.
Conclusion ED offers perioperative advantages and comparable efficacy but does not surpass MD due to TELD’s increased recurrence risk. IELD and UBE are promising alternatives, but MD remains the benchmark. Long-term RCTs are needed.
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Letter to Editor: Practice preference of revision surgery for recurrent lumbar disc herniation: an international survey of AO spine members Borriwat Santipas, Jin-Sung Kim European Spine Journal.2026;[Epub] CrossRef
Mohamed A.R. Soliman, Hendrick Francois, Alexander O. Aguirre, Asham Khan, Waeel Hamouda, Stipe Ćorluka, Zorica Buser, Samuel K. Cho, S. Tim Yoon, AO Spine Knowledge Forum Degenerative
Neurospine 2026;23(1):42-58. Published online January 31, 2026
Objective Lumbar discectomy is one of the most frequently undertaken procedures for the management of lumbar disc herniation. However, it may be complicated by recurrent disc herniation, with reported rates as high as 25%. To the authors’ knowledge, this study is the largest systematic review to date, analyzing the clinical and radiographic risk factors for recurrent disc herniation.
Methods A systematic literature search of Embase and PubMed/Medline, covering the period from inception to October 1, 2025, was conducted to identify case-control or cohort studies reporting risk factors for recurrent disc herniation. Risk factors were classified into baseline, clinical, and radiographic risk factors. Meta-analysis was performed for any reported risk factor with data from 3 or more studies. The assessment included an evaluation of publication bias and heterogeneity.
Results A total of 51 studies published during the search timeframe, comprising 52,479 patients, met the inclusion criteria. Recurrent disc herniation occurred in 6,794 patients (12.9%). Significant risk factors for disc herniation included high body mass index (BMI) (standard mean difference [SMD], 0.48; 95% confidence interval [CI], 0.26–0.70), diabetes (odds ratio [OR], 1.48; 95% CI, 1.23–1.77), increased sagittal range of motion (SMD, 2.15; 95% CI, 0.35–3.94), and Modic changes (OR, 2.97; 95% CI, 2.20–4.01). No other significant predictors for recurrent disc herniation were identified.
Conclusion In conclusion, patients with high BMI, diabetics, increased sagittal range of motion, and presence of Modic changes are at increased risk of recurrent disc herniation. Future prospective studies are needed to validate the risk factors identified in this study associated with recurrent disc herniation.
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Comparison of clinical efficacy and minimal invasiveness between unilateral biportal endoscopic and percutaneous endoscopic lumbar discectomy in the treatment of calcified lumbar disc herniation: a retrospective analysis Zhifeng Cheng, Lei Sun, Tao Tang, Qiang Wu, Likan Liang, Haonan Lu, Hao Xu, Bo Hu BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
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Luca Ambrosio, Sathish Muthu, Patrick C. Hsieh, S. Tim Yoon, Jeffrey C. Wang, Gianluca Vadalà, Hans Jörg Meisel, Stipe Ćorluka, Zorica Buser, AO Spine Knowledge Forum Degenerative
Neurospine 2026;23(1):31-39. Published online January 31, 2026
Objective This study aimed to characterize international practice patterns in the surgical management of primary lumbar disc herniation (LDH) among AO Spine surgeons.
Methods A cross-sectional online survey was distributed in September 2024 to AO Spine members. The questionnaire collected detailed information on demographic characteristics, surgical indications, preferred techniques, and approaches for primary LDH treatment. Data on specialty, practice setting, fellowship training, and surgical case volume were analyzed using univariate and multivariate logistic regression to identify significant associations between surgeon characteristics and treatment preferences.
Results A total of 714 surgeons participated, representing diverse regions: North America (9.0%), Latin America (18.7%), Europe & Southern Africa (34.7%), Middle East & Northern Africa (12.8%), and Asia Pacific (24.8%). Neurological status was the most critical factor influencing early operative treatment in nonurgent cases, while bladder/bowel dysfunction and severe motor deficits were the primary indications in urgent scenarios. The majority of respondents (54.2%) preferred a mini-open technique—using either a surgical microscope or loupes—with partial laminotomy (58.1%) and partial discectomy (63.2%) being the most frequently performed procedures. Regional variations and differences in surgeon training were significantly associated with the choice of surgical approach and overall case volume.
Conclusion The findings reveal substantial variability in the surgical management of primary LDH across regions and specialties. This comprehensive dataset underscores the need for standardized, evidence-based guidelines to harmonize treatment strategies and optimize patient outcomes.
Objective The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region.
Methods We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed.
Results A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001).
Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.
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Objective Full endoscopic cervical surgery (FECS) is an evolving minimally invasive approach for treating cervical spine disorders. This systematic review synthesizes current evidence on the clinical outcomes and patient perspectives associated with FECS, specifically evaluating its safety, efficacy, and overall patient satisfaction.
Methods A systematic search of the PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published between January 2000 and September 2024 that reported on clinical outcomes or patient perspectives related to FECS were included. Risk of bias was assessed using the ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) tool and the Cochrane Risk of Bias tool. Inclusion criteria encompassed randomized controlled trials, prospective cohort studies, retrospective studies, and observational studies focused on adult populations undergoing FECS for cervical spine surgery.
Results The final synthesis included 30 studies. FECS was associated with significant reductions in both cervical and radicular pain, as well as meaningful functional improvements, measured by standardized clinical scales such as the Neck Disability Index and visual analogue scale. Patient satisfaction rates were consistently high, with most studies reporting satisfaction exceeding 85%. Complication rates were low, primarily involving transient neurological deficits that were typically resolved without the need for further intervention. Nonrandomized studies generally presented a moderate risk of bias due to confounding and selection, whereas randomized controlled trials exhibited a low risk of bias.
Conclusion FECS is a safe and effective minimally invasive surgical option for cervical spine disorders associated with substantial pain relief, functional improvement and high levels of patient satisfaction.
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Objective This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH).
Methods A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups.
Results The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05).
Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.
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To demonstrate the preoperative workup, surgical planning and execution of transforaminal endoscopic thoracic discectomy (TETD) for a giant calcified disc herniation. Surgeries for symptomatic thoracic disc herniations are rare and challenging. The main goal is to achieve sufficient decompression with minimal manipulation of the spinal cord. Conventional surgical techniques may have significant approach-related morbidities and often require additional stabilization. The full endoscopic transforaminal technique is the least invasive approach so far. A 73-year-old female patient with progressive gait disturbance and paraparesis received radiological imaging which revealed a giant calcified thoracic disc herniation at the level T11–12. The preoperative workup, planning and execution of TETD is demonstrated in detail. This report represents a typical educational case of a giant calcified thoracic disc herniation, treated by TETD.
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The main objective of this case and video is to demonstrate the surgical technique of navigated full-endoscopic decompression and sequestrectomy at the C7–T1 level to alleviate C8 nerve root compression and manage cervicobrachialgia. Cervicobrachialgia resulting from C7–T1 disc herniation is a quite rare yet painful condition that can significantly impair motor function in the upper limb. Traditionally, open surgeries can be invasive, with prolonged recovery times and/or fusion of the level with adjacent segment disease. Posterior full-endoscopic approach offers a minimally invasive alternative that allows for quicker recovery, less postoperative pain, and improved outcomes. By preserving motion, it also prevents adjacent segment disease. A 72-year-old female presented with sudden-onset cervicobrachial pain radiating to the ulnar side of the right arm, coupled with paresthesia and weakness of the flexors/interosseous muscles (Medical Research Council=M3). Magnetic resonance imaging confirmed a large right-sided C7–T1 disc herniation compressing the C8 nerve root. A full-endoscopic C7–T1 posterior foraminotomy and sequestrectomy was performed with navigation. The patient experienced immediate relief from pain and improved motor function in the right hand postoperatively. Posterior full-endoscopic foraminotomy and sequestrectomy of the C7–T1 disc herniation is effective for treating cervicobrachialgia due to C8 nerve compression. The minimally invasive approach demonstrated in this video highlights the technique and stresses the advantage of navigation in the lower cervical spine.
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Objective To compare the safety profiles of biportal endoscopic spinal surgery (BESS) and microscopic spinal surgery (MSS) for lumbar disc herniation and spinal stenosis by analyzing the associated adverse events.
Methods We pooled data from 2 prospective randomized controlled trials involving 220 patients (110 in each group) who underwent single-level lumbar surgery. Participants aged 20–80 years with radiating pain due to lumbar disc herniation or spinal stenosis were included in this study. Adverse events were recorded and analyzed over a 12-month follow-up period.
Results The overall adverse event rates were 9.1% (10 of 110) in the BESS group and 17.3% (19 of 110) in the MSS group, which were not statistically significantly different (p=0.133). Notably, wound dehiscence occurred in 8.2% of MSS cases but in none of the BESS cases. Both groups showed similarly low rates of complications, such as dural tears, epidural hematoma, and nerve root injury. The most common adverse event in the BESS group was recurrent disc herniation (2.7%), whereas that in the MSS group was wound dehiscence (8.2%).
Conclusion BESS demonstrated a safety profile comparable to that of MSS for the treatment of lumbar disc herniation and spinal stenosis, with a trend towards fewer overall complications. BESS offers particular advantages in terms of reducing wound-related complications. These findings suggest that BESS is a safe alternative to conventional MSS and potentially offers the benefits of a minimally invasive approach without compromising patient safety.
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O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee Asian Spine Journal.2025; 19(2): 194. CrossRef
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Objective Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA.
Methods Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively.
Results Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups.
Conclusion Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.
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Full-Endoscopic Lumbar Discectomy: A Review of the Surgical Techniques, Indications and Anatomical Considerations Stylianos Kapetanakis, Mikail Chatzivasiliadis, Nikolaos Gkantsinikoudis, Konstantinos Pazarlis Journal of Clinical Medicine.2025; 14(24): 8961. CrossRef
Objective This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines.
Methods Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud.
Results In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model.
Conclusion In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.
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Evidence-Based Clinical Practice Guidelines for Patients With Lumbar Disc Herniation With Radiculopathy in South Korea Jong Joo Lee, Min Cheol Chang, Dong Ah Shin, Jin Hoon Park, Miyoung Choi, Hyung-Youl Park, In Soo Kim, Jung-Kil Lee, Chung-Kee Chough, Seung Hwan Yoon, Seong-Soo Choi, Sung-Woo Choi Neurospine.2025; 22(2): 366. CrossRef
Impact of BMI, osteoporosis, and disc degeneration on post-UBE lumbar stability: a finite element analysis of nonlinear synergistic effects Jingbo Ma, Tusheng Li, Rigbat Rozi, Jiaheng Han, Qiang Jiang, Hanshuo Zhang, Xuyan Song, Guotong Zhao, Yu Ding Frontiers in Bioengineering and Biotechnology.2025;[Epub] CrossRef
Biomechanical changes in lumbar intervertebral discs after percutaneous endoscopic transforaminal discectomy surgery at different Body Mass Index (BMI) categories Xiaohai Zhang, Jinghui Lin, Chen Liu, Shuangtao Xue, Mengying Wu, Zongsheng Yin Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
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