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KMID : 1040020220130010011
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International Journal of Pain
2022 Volume.13 No. 1 p.11 ~ p.19
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Narrative Review of Uniportal, Transforaminal Endoscopic Lumbar Discectomy
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Yuh Woon-Tak
Lee Chang-Hyun
Chung Chun-Kee
Kim Chi-Heon
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Abstract
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Since the first use of arthroscopy for lumbar spinal surgery in 1990, endoscopic lumbar spinal surgery has evolved both technically and instrumentally. Transforaminal endoscopic lumbar discectomy (TELD) was the first and remains the most commonly used method. This study aimed to review evidence of TELD in systematic reviews and randomized controlled trials (RCTs). This narrative review included systematic reviews and RCTs that compared TELD with open discectomy (OD), microdiscectomy (MD), or tubular retractor?assisted microendoscopic discectomy (MED). PubMed was searched using the following keywords: for RCTs, ((((lumbar) AND (spine)) AND (endoscope)) AND (randomized[Title])) AND (trial[Title])); and for systematic reviews, ((((lumbar) AND (spine)) AND (endoscope)) AND (systematic[Title/Abstract]))). Two spine surgeons ultimately included 6 RCTs and 4 systematic reviews in the study. The current study reviewed the clinical outcomes, complications, recurrence, and length of hospital stay of the included studies. There were no significant differences in clinical outcomes, complications, or recurrence rates between TELD and OD, MD, or MED. However, the length of hospitalization was lower and intraoperative bleeding was lower after TELD than after MD. The quality of the evidence was moderate. The clinical outcomes of TELD and OD, MD, and MED seemed similar with a moderate quality of evidence.
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KEYWORD
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endoscopes, lumbar vertebrae, review literature, spine, surgery
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