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Updated: Jan 28, 2026
10:09
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
4.5K
The Transiliac Approach: A Forgotten Alternative for Transforaminal Endoscopic Decompression at the L5-S1 Level in
Ajay Krishnan1,2, Abhijith Anil3,2, Shivanand C Mayi2
1Spine Surgery, Bhavnagar Institute of Medical Sciences, Bhavnagar, IND.
Cureus
|January 27, 2026
Summary
Transiliac transforaminal endoscopic lumbar discectomy (TI-TELD) offers a viable solution for ventral spinal compression, especially at L5-S1. This study shows TI-TELD provides sustained good outcomes and high patient satisfaction, making it suitable for outpatient settings.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Transforaminal endoscopic lumbar discectomy (TELD) is effective for ventral spinal pathology.
- Anatomical limitations at L5-S1 often hinder traditional TELD.
- Transiliac TELD (TI-TELD) presents a potential solution but is sparsely reported.
Purpose of the Study:
- To evaluate the outcomes of transiliac transforaminal endoscopic lumbar discectomy (TI-TELD) in patients with high iliac crest.
- To assess the long-term efficacy and safety of TI-TELD for ventral compressive pathology at the L5-S1 level.
Main Methods:
- Retrospective review of 93 patients undergoing TI-TELD between 2009 and 2021.
- Inclusion criteria: complete records and minimum two-year follow-up.
- Outcome measures: Visual Analog Scale (VAS), Oswestry Disability Index (ODI), patient satisfaction, and neurological recovery.
Main Results:
- Significant improvement in ODI scores from 79.8% preoperatively to 5.94% at two-year follow-up.
- High patient satisfaction reported by 82 out of 93 patients.
- Good recovery of motor power in 13 out of 16 patients with preoperative deficits.
- Mean return to work was 19.20 days post-surgery.
Conclusions:
- TI-TELD is an under-reported procedure with good, sustained outcomes and high patient satisfaction.
- Despite being more invasive than TELD, TI-TELD's advantages, including suitability for local anesthesia, make it ideal for ambulatory centers.
Keywords:
awake spine surgeryday care surgerylumbar disc herniationminimally invasive spine surgerytransforaminal endoscopytransiliac approachMore Related Videos
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