Transforaminal Percutaneous Endoscopic Discectomy Using Transforaminal Endoscopic Spine System Technique: Pitfalls That a Beginner Should Avoid

Overview

Journal World J Orthop

Publisher Baishideng Publishing Group

Specialty Orthopedics

Date 2018 Jan 10

PMID 29312845

Citations 12

Authors

Stylianos Kapetanakis

Grigorios Gkasdaris

Antonios G Angoules

Panagiotis Givissis

Affiliations

Soon will be listed here.

Abstract

Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

Citing Articles

Intraoperative Fluoroscopic Verification of Satisfactory Foraminotomy in Posterior Open Decompression Surgery for Lumbar Foraminal Stenosis: A Clinical Image.

Kapetanakis S, Bladowska J, Tsioulas P, Tsolakidis G, Siopis C, Gkantsinikoudis N Clin Case Rep. 2025; 13(2):e70231.

PMID: 39967845 PMC: 11832910. DOI: 10.1002/ccr3.70231.

Lumbar percutaneous transforaminal endoscopic discectomy: a retrospective survey on the first 172 adult patients treated in Denmark.

Terkelsen J, Hundsholt T, Bjarkam C Acta Neurochir (Wien). 2024; 166(1):155.

PMID: 38538955 PMC: 10973006. DOI: 10.1007/s00701-024-06038-6.

Transforaminal endoscopic lumbar discectomy: learning curve of a single surgeon.

Fleiderman V, Lecaros B, Cirillo T, Alvarez Lemos F, Osorio V, Wolff B J Spine Surg. 2023; 9(2):159-165.

PMID: 37435320 PMC: 10331491. DOI: 10.21037/jss-22-54.

Impact of Body Weight, Height, and Obesity on Selection of Skin Entry Point for Transforaminal Endoscopic Lumbar Discectomy.

Patgaonkar P, Goyal V, Agrawal U, Marathe N, Patel V Asian J Neurosurg. 2022; 17(2):262-267.

PMID: 36120643 PMC: 9473811. DOI: 10.1055/s-0042-1751005.

Puncture and localization for percutaneous endoscopic lumbar discectomy with C-arm navigation: a randomized controlled cadaver trial.

Qin H, Deng L, Xu L, Mu Q, Luo X, Huang S Ann Transl Med. 2022; 9(23):1730.

PMID: 35071424 PMC: 8743699. DOI: 10.21037/atm-21-5844.

References

Wu X, Fan G, Gu X, Shen T, Guan X, Hu A . Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study. J Zhejiang Univ Sci B. 2016; 17(7):553-60. PMC: 4940631. DOI: 10.1631/jzus.B1600002. View

Shin K, Chang H, Rhee N, Lim K . Revisional percutaneous full endoscopic disc surgery for recurrent herniation of previous open lumbar discectomy. Asian Spine J. 2011; 5(1):1-9. PMC: 3047892. DOI: 10.4184/asj.2011.5.1.1. View

Huang T, Wen-Wei Hsu R, Li Y, Cheng C . Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy. J Orthop Res. 2005; 23(2):406-11. DOI: 10.1016/j.orthres.2004.08.010. View

Stirling A, Howel D, Millner P, Sadiq S, Sharples D, Dickson R . Late-onset idiopathic scoliosis in children six to fourteen years old. A cross-sectional prevalence study. J Bone Joint Surg Am. 1996; 78(9):1330-6. DOI: 10.2106/00004623-199609000-00006. View

Lubbers T, Abuamona R, Elsharkawy A . Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level. Acta Neurochir (Wien). 2012; 154(10):1789-95. DOI: 10.1007/s00701-012-1432-z. View

Ohya J, Oshima Y, Chikuda H, Oichi T, Matsui H, Fushimi K . Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score-matched analysis using a nationwide administrative database. Neurosurg Focus. 2016; 40(2):E5. DOI: 10.3171/2015.10.FOCUS15479. View

Sairyo K, Matsuura T, Higashino K, Sakai T, Takata Y, Goda Y . Surgery related complications in percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Invest. 2014; 61(3-4):264-9. DOI: 10.2152/jmi.61.264. View

Jancuska J, Spivak J, Bendo J . A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome. Int J Spine Surg. 2015; 9:42. PMC: 4603258. DOI: 10.14444/2042. View

Gadjradj P, Harhangi B . Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disk Herniation. Clin Spine Surg. 2016; 29(9):368-371. DOI: 10.1097/BSD.0000000000000366. View

10.

Wang Y, Zhang W, An J, Zhang J, Bai J, Sun Y . Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation. Med Sci Monit. 2016; 22:2513-9. PMC: 4962756. DOI: 10.12659/msm.899510. View

11.

Nie H, Zeng J, Song Y, Chen G, Wang X, Li Z . Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Disc Herniation Via an Interlaminar Approach Versus a Transforaminal Approach: A Prospective Randomized Controlled Study With 2-Year Follow Up. Spine (Phila Pa 1976). 2016; 41 Suppl 19:B30-B37. DOI: 10.1097/BRS.0000000000001810. View

12.

Wu B, Zhang S, Lian Q, Yan H, Lin X, Zhan G . Lumbar Scoliosis Combined Lumbar Spinal Stenosis and Herniation Diagnosed Patient Was Treated with "U" Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy. Case Rep Orthop. 2017; 2017:7439016. PMC: 5288505. DOI: 10.1155/2017/7439016. View

13.

Jasper G, Francisco G, Telfeian A . Transforaminal endoscopic discectomy with foraminoplasty for the treatment of spondylolisthesis. Pain Physician. 2014; 17(6):E703-8. View

14.

Kim C, Chung C, Jahng T, Yang H, Son Y . Surgical outcome of percutaneous endoscopic interlaminar lumbar diskectomy for recurrent disk herniation after open diskectomy. J Spinal Disord Tech. 2012; 25(5):E125-33. DOI: 10.1097/BSD.0b013e31825bd111. View

15.

Kambin P, Brager M . Percutaneous posterolateral discectomy. Anatomy and mechanism. Clin Orthop Relat Res. 1987; (223):145-54. View

16.

Sairyo K, Egawa H, Matsuura T, Takahashi M, Higashino K, Sakai T . State of the art: Transforaminal approach for percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Invest. 2014; 61(3-4):217-25. DOI: 10.2152/jmi.61.217. View

17.

Kapetanakis S, Charitoudis G, Thomaidis T, Theodosiadis P, Papathanasiou J, Giatroudakis K . Health-related quality of life after transforaminal percutaneous endoscopic discectomy: An analysis according to the level of operation. J Craniovertebr Junction Spine. 2017; 8(1):44-49. PMC: 5324359. DOI: 10.4103/0974-8237.199872. View

18.

Bae J, Lee S . Transforaminal full-endoscopic lumbar discectomy in obese patients. Int J Spine Surg. 2016; 10:18. PMC: 4943208. DOI: 10.14444/3018. View

19.

Lee S, Kim S, Lee S, Kim W, Choi W, Choi G . Percutaneous endoscopic lumbar discectomy for migrated disc herniation: classification of disc migration and surgical approaches. Eur Spine J. 2006; 16(3):431-7. PMC: 2200706. DOI: 10.1007/s00586-006-0219-4. View

20.

Lee S, Kang H, Choi G, Kong B, Ahn Y, Kim J . Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level. Neurol Med Chir (Tokyo). 2011; 50(12):1074-8. DOI: 10.2176/nmc.50.1074. View