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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
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A Simplified and Efficient Transforaminal Endoscopic Lumbar Discectomy Technique With Reduced Radiation: A
Baozhi Ding1, Haijun Tian2, Jie Zhao3
1Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International Journal of Spine Surgery
|March 11, 2026
Summary
A modified transforaminal endoscopic lumbar discectomy (TELD) using a "Guiding Rod" simplifies procedures, reduces fluoroscopy, and improves patient outcomes for lumbar disc herniation. This technique enhances safety and efficiency in TELD surgery.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
- Spinal Endoscopy
Background:
- Transforaminal endoscopic lumbar discectomy (TELD) is complex, requiring significant fluoroscopy and a steep learning curve.
- Optimizing TELD procedures for lumbar disc herniation is crucial for improving surgical outcomes and patient safety.
Purpose of the Study:
- To introduce and evaluate a modified TELD technique using a "Guiding Rod" and visual trephine.
- To assess the impact of this modified technique on procedure efficiency, radiation exposure, and clinical outcomes.
Main Methods:
- Retrospective analysis of 76 patients undergoing modified TELD with a "Guiding Rod" and visual trephine.
- Recorded parameters included fluoroscopy frequency, positioning time, foraminoplasty time, operation time, and blood loss.
- Clinical outcomes were assessed using Visual Analog Scale, Japanese Orthopedic Association, and Oswestry Disability Index scores.
Main Results:
- The modified technique significantly reduced fluoroscopy frequency (3.93 ± 0.97 times) and positioning time (3.60 ± 1.10 minutes).
- Mean operation time was 48.38 ± 10.85 minutes with minimal blood loss (<15 mL) and no complications.
- Significant improvements were observed in all clinical scores postoperatively compared to preoperative values.
Conclusions:
- The modified TELD technique with a "Guiding Rod" and visual trephine offers improved ease of operation and safety.
- This approach optimizes TELD technology by minimizing radiation exposure and enhancing procedural efficiency.
- The study highlights advancements in transforaminal endoscopic discectomy techniques for lumbar disc herniation.
