ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
A technical report and pilot feasibility study of a novel minimally invasive tubular trans-isthmus oblique approach for upper lumbar disc herniation.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUpper lumbar disc herniations (L1-2, L2-3) present unique anatomical challenges due to narrow interlaminar windows and facet joint proximity. This pilot feasibility study aimed to evaluate the safety and short-term efficacy of a novel minimally invasive tubular trans-isthmus oblique approach for upper lumbar disc herniation, prior to a planned prospective trial.
methodsTwenty patients (13 males, 7 females; mean age 50.8 years) with imaging-confirmed L1-2 or L2-3 paracentral disc herniation and unilateral leg pain unresponsive to conservative management were enrolled between January 2022 and January 2024. All underwent decompression using the novel tubular trans-isthmus oblique approach designed to preserve the medial facet cortex. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for leg pain were assessed preoperatively and at 1, 3, 6, and 12 months. Modified Macnab criteria were recorded at 12 months. Dynamic radiographs and postoperative CT (in selected cases) assessed stability and facet preservation. Statistical analysis was performed using JASP v0.18 with Wilcoxon Signed Rank Test and Friedman test.
resultsMedian preoperative ODI was 83%, improving to 5% at 3 months (p < 0.001). VAS leg pain scores improved from a mean of 8.24 to 1, 0, and 0 at 1, 3, and 12 months respectively (p < 0.01). Seventeen patients had excellent outcomes, 2 good, and 1 fair per Macnab criteria. No recurrence or radiological instability was observed. One dural tear and one transient L2 dysesthesia resolved without sequelae.
conclusionTo the best of our knowledge, this is the first clinical study to describe and evaluate a minimally invasive tubular trans-isthmus oblique approach for upper lumbar disc herniation. The technique appears technically feasible and safe. These encouraging results support the need for larger prospective trials to confirm long-term outcomes and reproducibility.
Indexed as
Identifiers
41318870What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.