Objective:To compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and posterior small incision microdiscectomy (MD) in the treatment of recurrent lumbar disc herniation.Methods:A retrospective analysis was conducted on the data of 132 patients who underwent revision surgery for recurrent lumbar disc herniation at the same segment at Qilu Hospital of Shandong University between July 2012 and August 2022. The patients were treated with either PEID or MD. The PEID group consisted of 90 patients, including 51 males and 39 females, with a mean age of 42.7±11.3 years and a mean body mass index (BMI) of 23.7±3.4 kg/m 2. The surgical segments were L 4-5 in 38 cases and L 5S 1 in 52 cases. The primary surgeries included open discectomy in 7 cases, laminectomy with bone graft in 3 cases, MD in 35 cases, and PEID in 45 cases. The MD group consisted of 42 patients, including 30 males and 12 females, with a mean age of 41.2±12.6 years and a mean BMI of 24.3±4.7 kg/m 2. The surgical segments were L 4-5 in 19 cases and L 5S 1 in 23 cases. The primary surgeries included open discectomy in 2 cases, laminectomy with bone graft in 1 case, MD in 17 cases, and PEID in 22 cases. The visual analogue scale (VAS) scores for low back pain and leg pain, Oswestry disability index (ODI), immediate postoperative VAS score for surgical wound pain, intraoperative blood loss, surgical wound length, operation duration, length of hospital stay, and various complications before and after surgery were compared between the PEID and MD groups. Results:The operation duration in the PEID group was 81.7±11.3 min, that in the MD group was 85.2±9.5 min, but the difference was not statistically significant ( t=1.740, P=0.081). The intraoperative blood loss in the PEID group was 4.4±2.9 ml, the surgical wound length was 0.9±0.2 cm, and the length of hospital stay was 3.1±1.3 d, all significantly less than those in the MD group (26.6±10.3 ml, 3.4±1.1 cm, and 8.7±1.6 d, respectively), with statistically significant differences ( P<0.05). Both groups were followed up, with a mean follow-up duration of 24.4±5.5 months in the PEID group and 24.5±4.9 months in the MD group, and there was no statistically significant difference between the two groups ( t=0.101, P=0.920). Both the PEID and MD groups showed significant improvements in postoperative VAS scores for leg pain, VAS scores for low back pain, and ODI compared with preoperative values ( P<0.05). Additionally, the VAS score for surgical wound pain on the first postoperative day in the PEID group was 1.2±0.4, which was lower than that in the MD group (2.9±0.6), with a statistically significant difference ( t=19.261, P<0.001). The incidence rates of muscle weakness, postoperative sensory abnormalities, and dural tears in the PEID group were 12%(11/90), 27%(24/90), and 6%(5/90), respectively, significantly lower than those in the MD group [31%(13/42), 40%(17/42), and 33%(14/42), respectively], with statistically significant differences ( P<0.05). However, there were no statistically significant differences between the two groups in the incidence rates of recurrence, residual nucleus pulposus, spinal cord-like hypertension syndrome, subcutaneous wound infection, or intervertebral space infection ( P>0.05). No patients in either group developed retroperitoneal hematoma postoperatively. Conclusion:For patients with recurrent lumbar disc herniation after primary posterior surgery, PEID demonstrates equally excellent clinical efficacy compared with MD, with smaller surgical trauma and a lower incidence of complications.

Objective:To evaluate the role of ZIP7 in sepsis-induced cardiomyopathy in mice.Methods:Ninety wild-type and 90 cardiomyocyte-specific knockout ZIP7 (ZIP7 cKO) male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 2 groups using a random number table method: wild-type sham operation group (Sham group) and wild-type sepsis group (Sep group), ZIP7 cKO sham operation group (cKO + Sham group) and ZIP7 cKO sepsis group (cKO + Sep group), with 45 mice in each group. The sepsis-induced cardiomyopathy model was developed using the cecal ligation and puncture in anesthetized mice. Twenty mice were randomly selected to record the survival for 10 days postoperatively. At 18 h after surgery, the left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) were measured by echocardiography, and serum concentrations of cardiac troponin T (cTnT), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay. The contents of hydroxyl radical (·OH) and peroxynitrite anion (ONOO -) were determined using a colorimetric assay, the morphology of myocardial mitochondria was observed with a transmission electron microscope, and the expression of dynamin-related protein 1 (Drp1), mitofusin-2 (Mfn2), and optic atrophy 1 (Opa1) in myocardial tissues was detected using Western blot. Results:Compared to Sham group, the survival rate, LVEF and LVFS were significantly decreased, serum concentrations of cTnT, TNF-α and IL-6 were increased, the contents of ·OH and ONOO - in myocardial tissues were increased, the expression of Drp1 was up-regulated, the expression of Mfn2 and Opa1 was down-regulated ( P<0.05), myocardial cells exhibited mitochondrial swelling, and marked destruction of mitochondrial cristae was observed in Sep group, and no significant differences were found in the aforementioned parameters in cKO+ Sham group ( P>0.05). Compared to Sep group, the survival rate, LVEF and LVFS were significantly increased, serum concentrations of cTnT, TNF-α and IL-6 were decreased, the contents of ·OH and ONOO - in myocardial tissues were decreased, the expression of Drp1 was down-regulated, the expression of Mfn2 and Opa1 was up-regulated ( P<0.05), and mitochondrial swelling in myocardial cells was mild, with less dissolution and destruction of mitochondrial cristae in cKO+ Sep group. Conclusions:Myocardial ZIP7 can promote mitochondrial fusion and inhibit mitochondrial fission, potentially contributing to the mechanism of sepsis-induced cardiomyopathy in mice.

In February 2025, a local cluster outbreak caused by the D8 genotype Measles virus (MV) was first discovered in Henan Province. Epidemiological investigations and laboratory testing were conducted, including the collection of serum and throat swabs for MV IgM antibody and nucleic acid detection, virus isolation and genetic homology analysis. Measures such as close contact tracing, vaccination rate assessment and supplementary immunization activities were implemented, successfully preventing broader community transmission. A total of three cases were reported during the outbreak, including one imported-related adolescent and two secondary local adult cases. All cases presented with typical symptoms such as fever and rash. Both adult cases were complicated by pneumonia, with one case developing into severe pneumonia. MV genotyping showed that the two secondary cases were both the D8 genotype, with the viral sequences being completely homologous to the Kazakhstan strain. Among the close contacts, 98.2% were adults, and 142 individuals received emergency vaccination.

Objective To investigate the effects of regenerating islet-derived protein 3β(Reg3β)on intestinal function and glycolysis in septic mice,as well as its role in promoting lactylation.Methods ① In vivo experiments:a total of 36 adult male C57BL/6 mice,including wild-type(WT)and Reg3β knockout(KO)mice,were randomly divided into six groups using a random number table:WT sham group,WT cecal ligation and puncture(CLP)-induced sepsis group(WT CLP group),WT sham+Reg3β intervention group(WT sham group),WT CLP+Reg3β intervention group(WT CLP+Reg3β group),KO sham group,and KO CLP group(n=6 per group).Blood glucose levels were measured at 24 hours and 48 hours after modeling;At 48 hours after modeling,ileum tissues were collected for hematoxylin-eosin(HE)staining to observe histopathological changes,immunofluorescence staining was performed to assess the positive expression levels of lactylated proteins,Western blotting was used to detect the expression levels of lactylated proteins in ileum tissues.② In vitro experiments:Cultured RAW264.7 cells were randomly divided into four groups using a random number table:blank control group,lipopolysaccharide(LPS)-induced sepsis model group(LPS group),Reg3β group,and LPS+Reg3β group.After 24 hours of drug induction,cells were collected,and Western blotting was performed to measure the levels of lactylated proteins,the culture medium was collected to determine lactylation levels.Results ① Histopathological observations showed that compared with the WT CLP group,the WT CLP+Reg3β group exhibited milder villus breakage and inflammatory cell infiltration.The KO CLP group showed more severe damage,with significantly shortened intestinal villi and separation of the epithelial layer from the lamina propria.Compared with the WT CLP group,blood glucose levels were significantly higher in the KO CLP group(mmol/L:6.83±1.15 vs.4.78±1.37,P<0.05).Both Western blotting and immunofluorescence staining results indicated that,compared with the WT CLP group,lactylation levels were significantly decreased in the KO CLP group[lactylated protein expression(lactylated protein/β-actin):0.48±0.20 vs.0.78±0.09;positive lactylated protein expression(mean fluorescence intensity):59.84±6.02 vs.100.00±5.26,both P<0.01].② Western blotting results of RAW264.7 cells cultured for 24 hours showed that compared with the LPS group,the LPS+Reg3β group exhibited significantly increased lactylated protein expression levels(lactylated protein expression/β-actin:3.67±0.48 vs.1.64±0.49,P<0.01).Compared with the blank control group,the lactate levels in the culture medium of the LPS group were significantly increased(mmol/L:4.95±0.20 vs.3.82±0.09,P<0.01).Compared with the LPS group,the lactate levels in the culture medium of the LPS+Reg3β group were also significantly increased(mmol/L:6.03±0.32 vs.4.95±0.20,P<0.01).Conclusion Reg3β promotes intestinal protein lactylation and exerts a protective effect on the intestine in sepsis,suggesting that Reg3β may serve as a novel therapeutic target for sepsis.

BACKGROUND:Percutaneous kyphoplasty was a common surgical procedure for the treatment of osteoporotic vertebral compression fracture.However,there was no research to confirm whether percutaneous kyphoplasty could effectively correct the local kyphoplasty of the spine in patients over 80 years old with osteoporotic vertebral compression fracture.OBJECTIVE:To investigate the effect of percutaneous kyphoplasty on local kyphosis in super-aging patients with osteoporotic vertebral compression fracture.METHODS:Single-segment osteoporotic vertebral compression fracture patients treated with percutaneous kyphoplasty at the Department of Spinal Surgery,Peking University People's Hospital,from March 2016 to August 2022,were selected as the research cohort,and the follow-up data of patients in hospital and out-patient were collected.According to patients'age,patients were divided into the advanced age group(60-79 years old,n=126)and the super-aged group(＞80 years old,n=52).According to gender,body mass index,basic diseases(hypertension,diabetes,and cardiovascular diseases),fracture segments and the presence or absence of preoperative intravertebral cleft,the two groups of patients were matched 1:2 by propensity score matching.The lumbar CT values,injection amount of bone cement,preoperative and postoperative vertebral height,preoperative collapse rate of the vertebral body,preoperative and postoperative Cobb angle,recovery rate of Cobb angle,distance between the bone cement and anterior edge of the vertebral body,sagittal position of cement filling,contact between the bone cement and endplate,distance between the bone cement and vertebral endplates,bone cement distribution score,bone cement leakage,and vertebral refracture were compared between the two groups.RESULTS AND CONCLUSION:(1)After matching the propensity score,115 patients were included,with 71 patients in the advanced age group and 44 patients in the super-aged group.There was no statistically significant difference in baseline data,including gender,body mass index,hypertension ratio,diabetes ratio,cardiovascular disease ratio,fracture section,and preoperative intravertebral cleft,between the two groups(P＞0.05).The postoperative Cobb angle of the super-aged patients was significantly smaller than that of the elderly patients(P＜0.05).There was no significant difference in lumbar CT values,injection amount of bone cement,preoperative and postoperative vertebral height,preoperative collapse rate of the vertebral body,preoperative Cobb angle,recovery rate of Cobb angle,postoperative distance between the bone cement and anterior edge of the vertebral body,sagittal position of cement filling,contact between the bone cement and endplate,distance between the bone cement and vertebral endplates,bone cement distribution score,bone cement leakage,and vertebral refracture ratio between the two groups(P＞0.05).(2)These findings indicate that percutaneous kyphoplasty can effectively correct local kyphosis of the spine in super-aging patients with osteoporotic vertebral compression fractures.

Objective To explore the impact of an intelligent puncture navigation used by different physicians with varying years of experience to perform the lung puncture biopsy surgery.Methods A retrospective selection was conducted of 182 patients who completed lung puncture biopsy surgery.The primary parameters were recorded included puncture time,the number of needle adjust-ments,dose length product(DLP),and complications.The physicians were categorized into high-experience and low-experience groups based on their years of clinical practice.The differences of navigation guidance and manual puncture were compared between the two groups.Results The use of navigation guidance significantly reduced the procedure time for both groups of physicians(P<0.05).Additionally,for the low-experience group,navigation guidance notably decreased the number of needle adjustments(P<0.05)and reduced the radiation dose received by patients(P<0.05).Conclusion The application of intelligent puncture navigation can shorten the procedure time,reduce the number of needle adjustments,and lower the radiation dose received by patients in lung puncture biopsy procedures.It also bridges the operational performance gap between low-experience and high-experience physicians,making it a val-uable imaging-guided tool for widespread adoption.

Objective To evaluate the clinical effectiveness of single-incision intervertebral foraminotomy in treating double-segment lumbar spinal stenosis accompanied by lumbar disc herniation.Methods A retrospective analysis was conducted on 40 cases of double-segment lumbar spinal stenosis and lumbar disc herniation treated in our orthopedic(spinal surgery)department from March 2016 to May 2018.Among these cases,11 patients(Group A)were treated with percutaneous discectomy,13 patients(Group B)underwent percutaneous endoscopic discec-tomy,and 16 patients(Group C)received double-incision percutaneous surgery.General clinical data for all patients were recorded.Visual Analog Scale(VAS)scores,Japanese Orthopaedic Association(JOA)scores,and clinical outcomes were assessed at five different time points:preoperatively,immediately postoperatively,one week postoperatively,one month postoperatively,and at the final follow-up.Statistical analysis was performed on the collected data.Results The operation time,the number of fluoroscopies performed on the hands,the length of the skin incision,and patient satisfaction were all statistically significant(P<0.05).An interaction effect was observed between the operation time and the surgical procedure on both the VAS and JOA scores.Both the operation time and the surgical method had significant main effects on the VAS and JOA scores(P<0.05).Significant differences in VAS and JOA scores were found among the three groups immediately post-surgery,one week post-surgery,one month post-operation,and at the end of the study(P<0.05).Immediately after surgery,there were statistically significant differences in VAS and JOA scores among the three groups(P<0.05).One week post-surgery,there were also statistically significant differences in VAS scores among the three groups(P<0.05).Conclusions The single-incision intervertebral foramen technique is an effective approach for simultaneously addressing double-seg-ment lumbar spinal stenosis and lumbar disc herniation through decompression.This method boasts a shorter opera-tive duration,reduced intraoperative radiation exposure,and minimal tissue damage.Patient satisfaction is high,making it a valuable addition to clinical practice.

Objective:To explore the expression changes of nerve growth factor (NGF)/tropomyosin receptor kinase A (TrkA) signaling pathway of dorsal root ganglia (DRG) in incisional rat remifentanil-induced hyperalgesia and its effect on the expression of membrane delta opioid receptor (DOR).Methods:A total of 48 SPF male SD rats were randomly divided into 6 groups based on body weight matching, with 8 in each group, which were control group (infusion of 0.9% NaCl solution via the tail vein), incision pain group (incision pain model established using the Brennan method), remifentanil group (infusion of remifentanil via the tail vein), incision pain+ remifentanil model group (incision pain model established using the Brennan method, followed by infusion of remifentanil via the tail vein), NGF group and TrkA inhibitor group(established incision pain+ remifentanil model after intrathecal injection of NGF (0.06 μg/g) or K252a (0.3 μg/g, TrkA inhibitor)). Mechanical paw withdrawal threshold (PWT) was used to assess pain sensitivity in rats. Western blot was employed to measure the expression of NGF, TrkA, and the total DOR(tDOR) and the membrane DOR(mDOR) in DRG tissues. Immunoelectron microscopy was used to detect subcellular DOR expression in DRG. Data were processed using SPSS 24.0 software. Multiple comparisons among groups were conducted by repeated measures ANOVA or one-way ANOVA, and post-hoc comparisons were performed using the Bonferroni test.Results:(1) The results of pain behavior showed that there was a significant interaction effect between time and group in the comparison of PWT among the six groups of rats before and after intervention ( F=345.817, P<0.001). At each time point after intervention, the PWTs of the incision pain+ remifentanil group were lower than those of the incision pain group and remifentanil group, the PWTs of the NGF group were lower than those of the incision pain+ remifentanil group, and the PWTs of the TrkA inhibitor group were higher than those of the incision pain+ remifentanil group and NGF group (all P<0.05). (2)The Western blot results showed that there were statistically significant differences in the relative levels of NGF, TrkA, and mDOR in the DRG tissues of the six groups of rats ( F=156.2, 163.8, 421.2, all P<0.001). The levels of NGF, TrkA, and mDOR proteins in the incision pain+ remifentanil group (1.45±0.07, 1.46±0.04, 3.01±0.20) were higher than those in the incision pain group (1.25±0.05, 1.24±0.04, 1.84±0.05) and remifentanil group (1.24±0.04, 1.26±0.03, 1.84±0.04) (all P<0.05). The levels of NGF, TrkA, and mDOR in the NGF group (1.57±0.03, 1.58±0.07, 3.74±0.25) were higher than those in the incision pain+ remifentanil group (all P<0.05). The relative expression levels of TrkA, and mDOR in the TrkA inhibitor group (1.25±0.04, 1.68±0.07) were lower than those in the incision pain+ remifentanil group and the NGF group (all P<0.05). (3)The results of immunoelectron microscopy showed that there were statistically significant differences in the localization of DOR in the cell membrane, subcellular sites of synthesis pathways, and subcellular localization of degradation pathways among the six groups of rat DRG tissues ( F=140.3, 60.63, 60.28, all P<0.01). The DOR of the synthesis pathway of incision pain+ remifentanil group was higher than that of the incision pain group and remifentanil group, while the DOR of the synthesis pathway of NGF was higher than that of the incision pain+ remifentanil group.The DOR of the synthesis pathway of TrkA inhibitor group was lower than that of the incision pain+ remifentanil group and NGF group (both P<0.05). The DOR of the degradation pathway in the incision pain+ remifentanil group was lower than that in the incision pain group and remifentanil group, the DOR of the degradation pathway in the NGF group was lower than that in the incision pain+ remifentanil group, and the DOR of the degradation pathway in the TrkA inhibitor group was higher than that in the incision pain+ remifentanil group and NGF group (both P<0.05). Conclusion:The NGF/TrkA signaling pathway is involved in rat incisional pain-remifentanil hyperalgesia by upregulating the delta opioid receptor of the dorsal root ganglia.

Objective:To explore the expression changes of nerve growth factor (NGF)/tropomyosin receptor kinase A (TrkA) signaling pathway of dorsal root ganglia (DRG) in incisional rat remifentanil-induced hyperalgesia and its effect on the expression of membrane delta opioid receptor (DOR).Methods:A total of 48 SPF male SD rats were randomly divided into 6 groups based on body weight matching, with 8 in each group, which were control group (infusion of 0.9% NaCl solution via the tail vein), incision pain group (incision pain model established using the Brennan method), remifentanil group (infusion of remifentanil via the tail vein), incision pain+ remifentanil model group (incision pain model established using the Brennan method, followed by infusion of remifentanil via the tail vein), NGF group and TrkA inhibitor group(established incision pain+ remifentanil model after intrathecal injection of NGF (0.06 μg/g) or K252a (0.3 μg/g, TrkA inhibitor)). Mechanical paw withdrawal threshold (PWT) was used to assess pain sensitivity in rats. Western blot was employed to measure the expression of NGF, TrkA, and the total DOR(tDOR) and the membrane DOR(mDOR) in DRG tissues. Immunoelectron microscopy was used to detect subcellular DOR expression in DRG. Data were processed using SPSS 24.0 software. Multiple comparisons among groups were conducted by repeated measures ANOVA or one-way ANOVA, and post-hoc comparisons were performed using the Bonferroni test.Results:(1) The results of pain behavior showed that there was a significant interaction effect between time and group in the comparison of PWT among the six groups of rats before and after intervention ( F=345.817, P<0.001). At each time point after intervention, the PWTs of the incision pain+ remifentanil group were lower than those of the incision pain group and remifentanil group, the PWTs of the NGF group were lower than those of the incision pain+ remifentanil group, and the PWTs of the TrkA inhibitor group were higher than those of the incision pain+ remifentanil group and NGF group (all P<0.05). (2)The Western blot results showed that there were statistically significant differences in the relative levels of NGF, TrkA, and mDOR in the DRG tissues of the six groups of rats ( F=156.2, 163.8, 421.2, all P<0.001). The levels of NGF, TrkA, and mDOR proteins in the incision pain+ remifentanil group (1.45±0.07, 1.46±0.04, 3.01±0.20) were higher than those in the incision pain group (1.25±0.05, 1.24±0.04, 1.84±0.05) and remifentanil group (1.24±0.04, 1.26±0.03, 1.84±0.04) (all P<0.05). The levels of NGF, TrkA, and mDOR in the NGF group (1.57±0.03, 1.58±0.07, 3.74±0.25) were higher than those in the incision pain+ remifentanil group (all P<0.05). The relative expression levels of TrkA, and mDOR in the TrkA inhibitor group (1.25±0.04, 1.68±0.07) were lower than those in the incision pain+ remifentanil group and the NGF group (all P<0.05). (3)The results of immunoelectron microscopy showed that there were statistically significant differences in the localization of DOR in the cell membrane, subcellular sites of synthesis pathways, and subcellular localization of degradation pathways among the six groups of rat DRG tissues ( F=140.3, 60.63, 60.28, all P<0.01). The DOR of the synthesis pathway of incision pain+ remifentanil group was higher than that of the incision pain group and remifentanil group, while the DOR of the synthesis pathway of NGF was higher than that of the incision pain+ remifentanil group.The DOR of the synthesis pathway of TrkA inhibitor group was lower than that of the incision pain+ remifentanil group and NGF group (both P<0.05). The DOR of the degradation pathway in the incision pain+ remifentanil group was lower than that in the incision pain group and remifentanil group, the DOR of the degradation pathway in the NGF group was lower than that in the incision pain+ remifentanil group, and the DOR of the degradation pathway in the TrkA inhibitor group was higher than that in the incision pain+ remifentanil group and NGF group (both P<0.05). Conclusion:The NGF/TrkA signaling pathway is involved in rat incisional pain-remifentanil hyperalgesia by upregulating the delta opioid receptor of the dorsal root ganglia.

Objective:To compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and posterior small incision microdiscectomy (MD) in the treatment of recurrent lumbar disc herniation.Methods:A retrospective analysis was conducted on the data of 132 patients who underwent revision surgery for recurrent lumbar disc herniation at the same segment at Qilu Hospital of Shandong University between July 2012 and August 2022. The patients were treated with either PEID or MD. The PEID group consisted of 90 patients, including 51 males and 39 females, with a mean age of 42.7±11.3 years and a mean body mass index (BMI) of 23.7±3.4 kg/m 2. The surgical segments were L 4-5 in 38 cases and L 5S 1 in 52 cases. The primary surgeries included open discectomy in 7 cases, laminectomy with bone graft in 3 cases, MD in 35 cases, and PEID in 45 cases. The MD group consisted of 42 patients, including 30 males and 12 females, with a mean age of 41.2±12.6 years and a mean BMI of 24.3±4.7 kg/m 2. The surgical segments were L 4-5 in 19 cases and L 5S 1 in 23 cases. The primary surgeries included open discectomy in 2 cases, laminectomy with bone graft in 1 case, MD in 17 cases, and PEID in 22 cases. The visual analogue scale (VAS) scores for low back pain and leg pain, Oswestry disability index (ODI), immediate postoperative VAS score for surgical wound pain, intraoperative blood loss, surgical wound length, operation duration, length of hospital stay, and various complications before and after surgery were compared between the PEID and MD groups. Results:The operation duration in the PEID group was 81.7±11.3 min, that in the MD group was 85.2±9.5 min, but the difference was not statistically significant ( t=1.740, P=0.081). The intraoperative blood loss in the PEID group was 4.4±2.9 ml, the surgical wound length was 0.9±0.2 cm, and the length of hospital stay was 3.1±1.3 d, all significantly less than those in the MD group (26.6±10.3 ml, 3.4±1.1 cm, and 8.7±1.6 d, respectively), with statistically significant differences ( P<0.05). Both groups were followed up, with a mean follow-up duration of 24.4±5.5 months in the PEID group and 24.5±4.9 months in the MD group, and there was no statistically significant difference between the two groups ( t=0.101, P=0.920). Both the PEID and MD groups showed significant improvements in postoperative VAS scores for leg pain, VAS scores for low back pain, and ODI compared with preoperative values ( P<0.05). Additionally, the VAS score for surgical wound pain on the first postoperative day in the PEID group was 1.2±0.4, which was lower than that in the MD group (2.9±0.6), with a statistically significant difference ( t=19.261, P<0.001). The incidence rates of muscle weakness, postoperative sensory abnormalities, and dural tears in the PEID group were 12%(11/90), 27%(24/90), and 6%(5/90), respectively, significantly lower than those in the MD group [31%(13/42), 40%(17/42), and 33%(14/42), respectively], with statistically significant differences ( P<0.05). However, there were no statistically significant differences between the two groups in the incidence rates of recurrence, residual nucleus pulposus, spinal cord-like hypertension syndrome, subcutaneous wound infection, or intervertebral space infection ( P>0.05). No patients in either group developed retroperitoneal hematoma postoperatively. Conclusion:For patients with recurrent lumbar disc herniation after primary posterior surgery, PEID demonstrates equally excellent clinical efficacy compared with MD, with smaller surgical trauma and a lower incidence of complications.