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Related Experiment Video

Updated: Aug 26, 2025

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

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Assessing the Learning Process of Transforaminal Endoscopic Discectomy for Sciatica.

Pravesh Shankar Gadjradj1, Pieter Schutte2, Arnold Vreeling3

  • 1Department of Neurosurgery, Park Medical Center, Rotterdam, The Netherlands.

Neurospine
|October 7, 2022
PubMed
Summary
This summary is machine-generated.

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Defining Recurrent Lumbar Disc Herniation (RLDH): An International Survey Study.

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Operative time, recurrence, and complications throughout the initial learning curve in transforaminal endoscopic lumbar discectomy.

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This study tracked 3 surgeons learning percutaneous transforaminal endoscopic discectomy (PTED). Surgeons improved significantly by 15 cases, but more experience may be needed for optimal clinical outcomes in this minimally invasive sciatica treatment.

Area of Science:

  • Minimally Invasive Spine Surgery
  • Surgical Education
  • Spinal Endoscopy

Background:

  • Percutaneous transforaminal endoscopic discectomy (PTED) is an increasingly popular minimally invasive option for sciatica.
  • A significant learning curve is associated with PTED, yet its learning process has not been previously studied.
  • This study investigates the learning curve of surgeons acquiring PTED proficiency.

Purpose of the Study:

  • To assess the learning process and skill acquisition of surgeons performing PTED.
  • To identify key areas of improvement during the initial PTED learning curve.
  • To evaluate the effectiveness of validated assessment tools in tracking PTED skill development.

Main Methods:

  • Three spine surgeons underwent training and performed PTED, initially under supervision.
Keywords:
Endoscopic discectomyLumbar disc herniationRandomized controlled trialSciatica

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  • Skill acquisition was evaluated every 5 cases up to 20 cases using OSATS, GOALS, and a 10-step PTED checklist.
  • Data collection occurred alongside a multicenter randomized controlled trial.

    • Main Results:

    • Surgeons showed improvement in "time and motion," "respect for tissue," and "instrument handling" based on self-assessment.
    • Enhanced "depth perception" and "autonomy" were noted via GOALS assessment.
    • All surgeons mastered all 10 checklist steps by case 10; adequate performance of all steps was achieved by case 15 for one surgeon.

    Conclusions:

    • Percutaneous transforaminal endoscopic discectomy (PTED) can be successfully adopted through a stepwise learning process.
    • Most procedural steps are adequately performed after approximately 15 cases.
    • Further experience may be required for optimal clinical outcomes, highlighting the need for validated tools to define independent proficiency.