Initial Experience of Transforaminal Lumbar Endoscopic Discectomy in a Single Orthopedics Unit

Objectives The objective of this study is to report the initial surgical experience, challenges faced, and the preliminary outcomes of our cases. Materials and methods A retrospective analysis of the first 10 patients operated with TELD in our unit was performed. Ethical approval was obtained from the Hospital Review Committee of Hamad Medical Corporation. Preparation time and surgical time were used to determine the learning curve of the surgeons. The Oswestry Disability Index (ODI) scores, which are routinely recorded preoperatively and then at two weeks and three months postoperatively, were used to assess the outcomes in this study. All the data was extracted from patients' records. The procedures were performed by two orthopedic spine surgeons. A total of 12 cases were booked for the TELD from April 2023 to February 2024. Two cases were converted to microscopic discectomy intraoperatively due to difficult access, and they were excluded from the study. Results Ten cases underwent TELD at the (L3/L4 - 1 case, L4/L5 - 8 cases and L5/ S1- 1 case) levels. All patients were male, and the mean age was 37.9 years (range: 24 to 48 years). Preparation time remained almost stable, while a downward trend was noticed in surgical time after the fourth case. The first and eighth operated cases did not show significant improvement in the ODI scores. The remaining patients had significant improvement in ODI scores, especially at three months postoperatively. Conclusion By virtue of our preliminary experience of the TELD, we realized that it is a useful procedure in properly selected patients with all the benefits of minimally invasive surgery. However, we found a relatively late resolution of preoperative symptoms as indicated by the ODI scores.