Related Experiment Video
Updated: Jul 4, 2026
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Transforaminal versus interlaminar endoscopic approach for broad-based lumbar disc herniation under standardized
Haoran Gao1, Yongxin Zhou1, Kejun Hu1
1Department of Orthopedics, The First Affiliated Hospital of Xi'an Medical University, Xi'an, China.
Objective:
This study aims to compare the clinical outcomes of the transforaminal approach (TFA) and interlaminar approach (ILA) for broad-based lumbar disc herniation (BLDH) under a standardized postoperative mecobalamin regimen. The primary focus is on dynamic changes in Visual Analog Scale (VAS) pain scores and Oswestry Disability Index (ODI) outcomes.
Methods:
This retrospective study included 184 patients with single-segment BLDH treated between June 2023 and October 2024 (89 in the TFA group and 95 in the ILA group). Both groups received the same postoperative mecobalamin regimen. Outcomes included the prespecified primary outcome of VAS score at 3 months postoperatively, as well as secondary outcomes including ODI, operative parameters, modified MacNab efficacy, neurological function, complications, and quality of life. Multivariable-adjusted analyses were performed to reduce potential selection bias.
Results:
Compared with TFA, ILA was associated with lower VAS scores at 3 months postoperatively (the prespecified primary outcome) and lower ODI at 3 days postoperatively (both p < 0.05). Additionally, the ILA group showed shorter operative time, fewer intraoperative fluoroscopies, and a greater volume of removed nucleus pulposus (all p < 0.05). Neurological indicators improved in both groups after treatment, without significant between-group differences. Clinical efficacy and complication rates were comparable between groups. In adjusted analyses, ILA remained significantly associated with lower ODI at 3 days (B = -2.883, 95% CI: -4.911 to -0.855, p = 0.006) and lower VAS scores at 3 months (B = -0.707, 95% CI: -0.930 to -0.485, p < 0.001).
Conclusion:
Under the same standardized postoperative mecobalamin treatment background, ILA is associated with better early postoperative recovery than TFA in patients with BLDH. These findings primarily reflect differences between the two surgical approaches rather than an independent effect of mecobalamin.
