Paravertebrally-Injected Multifunctional Hydrogel for Sustained Anti-Inflammation and Pain Relief in Lumbar Disc Herniation

The usefulness and utilisation of Lu's retractor for unilateral biportal endoscopic discectomy: a retrospective cohort study

BACKGROUND

A novel endoscopic instrument, Lu's retractor, was developed to address the recurrent issue of limited visualisation during unilateral biportal endoscopic (UBE) spinal surgery. Engineered to optimize the surgical field by mitigating soft tissue interference, this device aims to enhance operative precision and efficiency.

METHODS

This single-center retrospective cohort study analyzed 90 consecutive patients who underwent single-level lumbar discectomy via the UBE technique between June 2023 and June 2024. Based on the type of retractor utilised, patients were categorized into three groups: traditional retractor-assisted UBE discectomy (T-UBE), metal retractor-assisted UBE discectomy (M-UBE), and Lu's retractor-assisted UBE discectomy (Lu-UBE). Perioperative parameters-including operative duration, intraoperative blood loss, and complication incidence-along with clinical outcomes, were systematically recorded and compared to assess the relative efficacy of each retractor.

RESULTS

The Lu-UBE group exhibited significantly reduced hospital stays and intraoperative haemorrhage compared to the T-UBE and M-UBE cohorts. Furthermore, this group reported lower numerical rating scale (NRS) scores for both lumbar and radicular pain, alongside decreased Oswestry Disability Index (ODI) scores. Final follow-up assessments indicated superior Macnab grades, denoting improved functional recovery, and a lower incidence of postoperative complications.

CONCLUSION

Lu's retractor offers notable advantages over conventional and metal retractors in lumbar UBE discectomy by enhancing intraoperative visualization and minimizing complications. These findings support its potential utility as an effective alternative in minimally invasive spinal procedures.

Nanoparticle-Reinforced Hydrogel with a Well-Defined Pore Structure for Sustainable Drug Release and Effective Wound Healing

Impaired chronic wounds are a common complication of diabetes. Inhibited angiogenesis and dysfunctional inflammation render diabetic wound healing a critical challenge. Herein, a sustainable therapeutic composite hydrogel is presented for diabetic wound healing, consisting of a cocktail formulation of anti-inflammatory and local anesthetic nanoparticles incorporated into a composite hydrogel. The surface-modified drug nanoparticles are loaded into the biocompatible hydrogels and cross-linked with a gel precursor to enhance the structure. The sustainable delivery system achieves more than 90% drug release, with a total therapy duration tunable from 4 to 72 h. Through the long-lasting anti-inflammatory and analgesic effects of the composite hydrogel, diabetic wounds are swiftly transitioned into the proliferation phase, augmenting the survival and migration of keratinocytes and facilitating neovascularization and collagen alignment in diabetic wounds. These effects significantly improve the wound healing rate and skin regeneration process, achieving a healing rate that is 17 times that of untreated wounds. This study demonstrates that the hydrogel platform loaded with cocktail drug nanoparticles is promising for the rapid healing of diabetic wounds.

Advanced Hydrogel Systems for Local Anesthetic Delivery: Toward Prolonged and Targeted Pain Relief

Local anesthetics (LAs) have been indispensable in clinical pain management, yet their limitations, such as short duration of action and systemic toxicity, necessitate improved delivery strategies. Hydrogels, with their biocompatibility, tunable properties, and ability to modulate drug release, have been extensively explored as platforms for enhancing LA efficacy and safety. This narrative review explores the historical development of LAs, their physicochemical properties, and clinical applications, providing a foundation for understanding the integration of hydrogels in anesthetic delivery. Advances in thermoresponsive, stimuli-responsive, and multifunctional hydrogels have demonstrated significant potential in prolonging analgesia and reducing systemic exposure in preclinical studies, while early clinical findings highlight the feasibility of thermoresponsive hydrogel formulations. Despite these advancements, challenges such as burst release, mechanical instability, and regulatory considerations remain critical barriers to clinical translation. Emerging innovations, including nanocomposite hydrogels, biofunctionalized matrices, and smart materials, offer potential solutions to these limitations. Future research should focus on optimizing hydrogel formulations, expanding clinical validation, and integrating advanced fabrication technologies such as 3D printing and artificial intelligence-driven design to enhance personalized pain management. By bridging materials science and anesthetic pharmacology, this review provides a comprehensive perspective on current trends and future directions in hydrogel-based LA delivery systems.