[Percutaneous transforaminal endoscopic discectomy through different approaches for lumbar disc herniation]

Area of Science:

• Minimally Invasive Spine Surgery
• Spinal Endoscopy
• Neurosurgery

Context:

• Lumbar disc herniation (LDH) presents significant challenges for surgical treatment.
• Traditional open surgery for LDH involves considerable invasiveness and longer recovery times.
• Percutaneous transforaminal endoscopic discectomy (PTED) emerged as a less invasive alternative.

Purpose:

• To review the indications, approaches, methods, clinical efficacy, and complications of PTED for LDH.
• To highlight the evolution of PTED techniques, including newer interlaminar and transiliac approaches.
• To address factors contributing to PTED failure and emphasize proper patient and technique selection.

Summary:

• PTED offers advantages over open surgery for LDH, including minimal invasiveness, preserved spinal stability, and faster recovery.
• The transforaminal approach has limitations, but advancements like interlaminar and transiliac routes have broadened PTED's applicability.
• Non-standardized techniques and incorrect indication or approach selection are primary causes of PTED failure.

Impact:

• PTED, particularly with expanded approaches, represents a significant advancement in minimally invasive spine surgery for LDH.
• Understanding the nuances of different PTED approaches is crucial for optimizing surgical outcomes and minimizing complications.
• This review provides a comprehensive overview to guide clinicians in the effective application of PTED for lumbar disc herniation.