{
  "abstract": "Background\n\nWhether advanced disc degeneration affects outcomes after annular suture repair remains uncertain. This study evaluated the association of Pfirrmann grade IV with 12-month outcomes and MRI-confirmed symptomatic recurrence among selected patients undergoing interlaminar full-endoscopic lumbar discectomy with successful annular suture repair.Methods\n\nThis single-center retrospective cohort included 226 patients treated between May 2023 and March 2025. Patients were classified as Pfirrmann grades I-III (n = 151) or grade IV (n = 75). The primary estimands were ATT-IPTW-adjusted between-group differences in VAS-back, VAS-leg, and ODI at 12 months. Weighted generalized estimating equations assessed longitudinal trajectories. Modified MacNab outcomes and MRI-confirmed symptomatic recurrence were secondary outcomes; postoperative MRI was symptom-triggered.Results\n\nAt 12 months, adjusted grade IV-minus-grades I-III differences were 0.070 for VAS-back (95% CI, -0.270-0.409), -0.005 for VAS-leg (95% CI, -0.334-0.325), and 0.297 for ODI (95% CI, -1.180-1.774). Results were consistent in propensity-score-matched, grades III-IV restricted, and ordinal sensitivity analyses. Excellent/good modified MacNab outcomes occurred in 93.4% and 92.0% of patients, respectively. MRI-confirmed symptomatic recurrence occurred in 6/151 and 2/75 patients. Recurrence analyses were exploratory because only eight events occurred.Conclusions\n\nAmong selected patients with successful annular suture repair, Pfirrmann grade IV was not associated with a clinically important disadvantage in 12-month pain or functional outcomes. No increased recurrence signal was observed, but the study cannot determine whether Pfirrmann grade affects surgical candidacy, repairability, or successful closure.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lei Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Haoyun Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Song Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xin Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunchuan Gou"
    },
    {
      "affs": [
        0
      ],
      "name": "Jikun Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Pin Xie"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Rigao Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ah9vvfwhvtsdz.bib",
  "cited_by": 0,
  "doi": "10.3389/fsurg.2026.1924468",
  "fulltext_url": "https://europepmc.org/articles/PMC13686989",
  "id": "ah9vvfwhvtsdz",
  "issns": [
    "2296-875X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923219",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Spine and Intervertebral Disc Pathology"
    ]
  ],
  "openalex": "W7221003570",
  "pdf_url": "https://europepmc.org/articles/PMC13686989?pdf=render",
  "pmcid": "PMC13686989",
  "pmid": "42923219",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ah9vvfwhvtsdz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42923219",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923219"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Spinal Fractures and Fixation Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Association of preoperative Pfirrmann grade with 12-month outcomes after interlaminar full-endoscopic lumbar discectomy with successful annular suture repair: a single-center retrospective cohort study.",
  "title_text": "Association of preoperative Pfirrmann grade with 12-month outcomes after interlaminar full-endoscopic lumbar discectomy with successful annular suture repair: a single-center retrospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/ah9vvfwhvtsdz",
  "venue": "Frontiers in surgery",
  "versions": []
}