Endoscopic Transforaminal versus Interlaminar Discectomy in Management of Lumbar Disc Herniation: A Systematic Review of Outcomes and Complications

Abstract Background Lumbar herniated discs are common manifestations of degenerative spine diseases, being the main cause of radiated lower back pain. Aim of the Work The aim of this study is to compare between the transforaminal approach and the interlaminar approach in the incidence of complications and clinical prognosis scores in patients with lumbar disc herniation. Patients and Methods Literature searches was conducted using the following databases:” PubMed, Web of Science, ScienceDirect, Scopus, Cochrane Library, Google Scholar, Medline” using the following key words: “percutaneous transforaminal endoscopic discectomy, percutaneous interlaminar endoscopic discectomy, operative complications, minimally invasive, discectomy, endoscopic” from studies published after 2010. Results Although there is no significant difference between the two groups of comparison regarding percentage of postoperative complications, VAS scores, or ODI scores, However, PEID was superior to PETD regarding fluoroscopy times and operative time. The increased radiation exposure might be caused by the higher iliac crest, narrower foramina, or larger facet joints, which increased the difficulty of percutaneous puncture. Repeated fluoroscopy must be used to guide the puncture. In addition, the hypertrophy of ligamenta flava might also contribute to the difficulty of puncture and further increase radiation exposure in the PETD group. Conclusion This review provides evidence that both PEID and PETD are safe, effective, and minimally invasive surgical methods for the treatment of lumbar disc herniation, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed.