Percutaneous Transforaminal Endoscopic Discectomy: Surgical Techniques, Indications, and Outcomes

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Endoscopy

Background:

• Percutaneous transforaminal endoscopic discectomy (PTED) is an increasingly popular minimally invasive surgical technique.
• It is used to treat symptomatic lumbar disc herniation (LDH) by enabling direct access to and removal of disc fragments.

Purpose of the Study:

• To describe the technique, indications, advantages, and outcomes of PTED.
• To compare PTED with traditional discectomy methods.

Main Methods:

• PTED involves advancing a spinal endoscope through a transforaminal approach under fluoroscopic guidance.
• Disc fragments are removed using endoscopic instruments, followed by verification of decompression.

Main Results:

• PTED offers advantages over open and tubular discectomy, including smaller incisions, local anesthesia feasibility, and preservation of spine stability.
• Pooled complication rates are low (4.6%), with high patient satisfaction and significant pain reduction reported.
• Outcomes are comparable to open discectomy, with shorter hospital stays.

Conclusions:

• PTED is a safe and effective procedure for select patients with LDH.
• It provides comparable outcomes to open discectomy with added benefits of minimally invasive surgery.
• Considerations include the learning curve and potential challenges in specific anatomical locations.