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Professor Song En's Team Completes AUSS-Assisted Nucleus Pulposus Removal Combined with Annulus Fibrosus Suture in Almaty, Kazakhstan
Date：2026-09-10 Read：
Recently, the team led by Professor Song En from the First Affiliated Hospital of Kunming Medical University traveled to Almaty, Kazakhstan, where, in collaboration with Professor Li Jizheng, they successfully performed arthroscopic-assisted uni-portal spinal surgery (AUSS) — nucleus pulposus removal combined with annulus fibrosus suture — on a 35-year-old male patient with lumbar disc herniation. During the procedure, as the annular defect beneath the axilla of the nerve root was relatively large, Professor Song En decided to skillfully use a domestically produced annulus suture device to complete a fence-type annular suture, achieving a secure and tight closure of the defect. This cross-border surgery is yet another successful practice of taking the annulus suture technique to the world stage to serve patients in countries along the Belt and Road Initiative. It marks the recognition of minimally invasive spinal repair technology by international peers and fully demonstrates the international influence and commitment of Chinese spinal surgery.
Case Presentation
The patient was a 35-year-old male who presented to a local hospital in Almaty with low back pain accompanied by pain in the left lower limb. Lumbar MRI revealed an L5–S1 disc herniation extending posteriorly and slightly to the left of the midline, with compression of the corresponding dural sac and the left nerve root. The patient's symptoms recurred repeatedly, and conservative treatment yielded poor results, seriously affecting his work and daily life.
（Fig. 1 Preoperative imaging of the patient）
After arriving in Almaty, Professor Song En's team, together with Professor Li Jizheng, jointly assessed the patient's condition. Based on the imaging findings and the clinical signs and symptoms, the responsible segment was identified as L5/S1, and it was decided to perform AUSS-assisted nucleus pulposus removal combined with annulus fibrosus suture at the L5/S1 segment. During the operation, after removing the nucleus pulposus, Professor Song En's exploration revealed that the annular defect was located beneath the axilla of the nerve root and was relatively large, making effective closure difficult to achieve with conventional suture methods. The team therefore decided to switch to a fence-type annular suture technique to achieve a tight closure of the defect beneath the nerve root axilla, effectively reducing the risk of postoperative disc reherniation. Professor Li Jizheng cooperated throughout the procedure, and the surgery went smoothly.
（Fig. 2 Professor Song En and Professor Li Jizheng performing AUSS-assisted nucleus pulposus removal + annulus fibrosus suture at the L5/S1 segment on the patient）
（Fig. 3 Result of the fence-type annular suture.）
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