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Updated: Aug 6, 2025
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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
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Comparison of Full Endoscopic Lumbar Diskectomy Using the Transforaminal Approach versus Interlaminar Approach for
Ming-Tao Zhu1, Bao-Shan Hu2,3, Chien-Min Chen4,5
1Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China.
Summary
Transforaminal full endoscopic lumbar diskectomy (T-FELD) and interlaminar full endoscopic lumbar diskectomy (I-FELD) show similar clinical outcomes and safety for L5-S1 disc herniation. I-FELD offers shorter operative and fluoroscopy times compared to T-FELD.
Area of Science:
- Minimally Invasive Spine Surgery
- Neurosurgery
- Orthopedic Surgery
Background:
- Transforaminal full endoscopic lumbar diskectomy (T-FELD) and interlaminar full endoscopic lumbar diskectomy (I-FELD) are utilized for L5-S1 disc herniation.
- Existing research on their comparative effectiveness presents mixed findings.
- A systematic review and meta-analysis is needed to clarify perioperative outcomes, clinical results, and complication profiles.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of T-FELD versus I-FELD for treating L5-S1 lumbar disk herniation (LDH).
- To compare perioperative outcomes, clinical results (VAS, ODI), and complication rates between T-FELD and I-FELD.
- To conduct an in-depth examination of complication features associated with each technique.
Main Methods:
- Systematic literature search across multiple databases for relevant studies.
- Inclusion criteria applied to select studies comparing T-FELD and I-FELD for L5-S1 LDH.
- Data extraction and analysis of perioperative metrics, clinical outcomes (VAS, ODI), and complication data.
Main Results:
- Eight studies involving 756 patients were analyzed.
- No significant differences were found in postoperative bed rest or hospitalization duration.
- T-FELD demonstrated significantly longer fluoroscopy and operative times compared to I-FELD (p < 0.0001).
- Preoperative and postoperative VAS and ODI scores were comparable between both techniques.
- Rates of overall complications, specific complications (dysesthesia, pain, incomplete decompression), recurrence, and need for open surgery conversion were similar.
Conclusions:
- Both T-FELD and I-FELD offer comparable clinical effectiveness and safety profiles for L5-S1 LDH treatment.
- I-FELD is associated with reduced fluoroscopy and operative times compared to T-FELD.
- The choice between T-FELD and I-FELD may depend on surgeon preference and specific patient factors, considering the time efficiencies of I-FELD.
