The clinical efficacy of magnetic resonance neurography-assisted percutaneous transforaminal endoscopic discectomy.
- 1Department of Imaging, The Third People's Hospital of Bengbu, Bengbu, China.
- 2Department of Imaging, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
- 3Department of Orthopedics, The Third People's Hospital of Bengbu, Bengbu, China.
Abstract
Conventional magnetic resonance imaging (MRI) is an imaging modality routinely used for the diagnosis of lumbar disc herniation (LDH). Conversely, magnetic resonance neurography (MRN), a novel magnetic resonance (MR)-based technique, has not yet been widely applied in the clinical management of LDH. This study aimed to evaluate the efficacy of combining MRN with MRI in guiding percutaneous transforaminal endoscopic discectomy (PTED) and to explore the potential clinical value of MRN. Patients with LDH who met the inclusion criteria and were admitted to the Department of Orthopedics, Bengbu Third People's Hospital between April 2021 and April 2025 were retrospectively enrolled in the study. A total of 80 patients were included in the study (40 per group) and allocated to a control group (MRI only) and an observation group (MRI combined with MRN) based on whether a preoperative MRN examination was performed. Operative duration, the number of X-ray fluoroscopy sessions, the number of puncture attempts, intraoperative blood loss, and postoperative hospital stay were compared between the groups. Visual Analog Scale (VAS) and Japanese Orthopedic Association (JOA) scores were assessed at baseline, on postoperative day 1, and at 1-, 3-, 6-, and 12-month follow-ups. Correlations between MRN parameters of the lumbosacral nerve on the affected and unaffected sides and preoperative JOA scores were further analyzed in the observation group. We compared the characteristics of the two groups of patients, baseline characteristics, including sex and age, were comparable between the two groups (P>0.05). In the observation group, the morphology and course of the nerve roots were visualized more clearly, providing valuable information for preoperative surgical planning. The observation group exhibited superior outcomes in terms of operative duration, the number of X-ray fluoroscopy sessions, the number of puncture attempts, and intraoperative blood loss compared with the control group (P<0.01); however, no significant difference in postoperative hospital stay was observed (P>0.05). Lower VAS scores were observed in the observation group at the 12-month postoperative follow-up, while higher JOA scores were observed at the 3-, 6-, and 12-month postoperative follow-ups (P<0.001). Significant differences in nerve root diameter, dorsal root ganglion length, and signal intensity were detected between the affected and unaffected sides in the observation group (P<0.05). Further, the difference in signal intensity was significantly correlated with the preoperative JOA score (r=0.721, P<0.001). Preoperative MRN examination may facilitate preoperative assessment and surgical planning compared with conventional imaging modalities. The inter-side differences in MRN signal intensity parameters between the affected and unaffected sides, together with their observed correlations with JOA scores, provide preliminary evidence of the potential prognostic value of MRN.
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BibTeX
@article{wu2026clinical,
title = {{The clinical efficacy of magnetic resonance neurography-assisted percutaneous transforaminal endoscopic discectomy.}},
author = {Bailong Wu and Lin Wang and Bo Yang and Lei Wang and Zhiyue Wang and Bingjun Lei and Xiuli Zhang},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = sep,
doi = {10.21037/qims-2026-1-0273},
url = {https://europepmc.org/article/MED/42997776},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The clinical efficacy of magnetic resonance neurography-assisted percutaneous transforaminal endoscopic discectomy.
AU - Bailong Wu
AU - Lin Wang
AU - Bo Yang
AU - Lei Wang
AU - Zhiyue Wang
AU - Bingjun Lei
AU - Xiuli Zhang
PY - 2026
DA - 2026/09/30
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-1-0273
UR - https://europepmc.org/article/MED/42997776
AB - Conventional magnetic resonance imaging (MRI) is an imaging modality routinely used for the diagnosis of lumbar disc herniation (LDH). Conversely, magnetic resonance neurography (MRN), a novel magnetic resonance (MR)-based technique, has not yet been widely applied in the clinical management of LDH. This study aimed to evaluate the efficacy of combining MRN with MRI in guiding percutaneous transforaminal endoscopic discectomy (PTED) and to explore the potential clinical value of MRN. Patients with LDH who met the inclusion criteria and were admitted to the Department of Orthopedics, Bengbu Third People's Hospital between April 2021 and April 2025 were retrospectively enrolled in the study. A total of 80 patients were included in the study (40 per group) and allocated to a control group (MRI only) and an observation group (MRI combined with MRN) based on whether a preoperative MRN examination was performed. Operative duration, the number of X-ray fluoroscopy sessions, the number of puncture attempts, intraoperative blood loss, and postoperative hospital stay were compared between the groups. Visual Analog Scale (VAS) and Japanese Orthopedic Association (JOA) scores were assessed at baseline, on postoperative day 1, and at 1-, 3-, 6-, and 12-month follow-ups. Correlations between MRN parameters of the lumbosacral nerve on the affected and unaffected sides and preoperative JOA scores were further analyzed in the observation group. We compared the characteristics of the two groups of patients, baseline characteristics, including sex and age, were comparable between the two groups (P>0.05). In the observation group, the morphology and course of the nerve roots were visualized more clearly, providing valuable information for preoperative surgical planning. The observation group exhibited superior outcomes in terms of operative duration, the number of X-ray fluoroscopy sessions, the number of puncture attempts, and intraoperative blood loss compared with the control group (P<0.01); however, no significant difference in postoperative hospital stay was observed (P>0.05). Lower VAS scores were observed in the observation group at the 12-month postoperative follow-up, while higher JOA scores were observed at the 3-, 6-, and 12-month postoperative follow-ups (P<0.001). Significant differences in nerve root diameter, dorsal root ganglion length, and signal intensity were detected between the affected and unaffected sides in the observation group (P<0.05). Further, the difference in signal intensity was significantly correlated with the preoperative JOA score (r=0.721, P<0.001). Preoperative MRN examination may facilitate preoperative assessment and surgical planning compared with conventional imaging modalities. The inter-side differences in MRN signal intensity parameters between the affected and unaffected sides, together with their observed correlations with JOA scores, provide preliminary evidence of the potential prognostic value of MRN.
SN - 2223-4292
SN - 2223-4306
ER -