Comparison of Interlaminar and Transforaminal Approaches in Endoscopic Lumbar Discectomies

Abstract

Objective: In this study, we aim to compare total surgical time and length of hospital stay for the interlaminar endoscopic lumbar discectomy (IELD) and transforaminal endoscopic lumbar discectomy (TELD). Methods: This is a retrospective observational study in which we collected data from one center’s medical records, from March 2022 to February 2023, of patients who underwent uniportal endoscopic lumbar discectomies. The following data were collected: age, gender, endoscopic approach, length of stay, total surgical time, and surgical levels. The data were applied to a nonparametric test, the Mann-Whitney U test. A type I error of up to 5% was accepted as a statistically significant difference. Results: From the total of 107 patients (49 males and 58 females), the median duration of hospital stay was 19 hours. The most common surgical level was L5-S1, and the interlaminar uniportal endoscopic approach was performed in 87.85% of the cases. A significant statistical difference was observed in the total surgical time when comparing the interlaminar approach with the transforaminal approach when all levels (L2-L3 to L5-S1) are considered together in the analysis. Ultimately, no statistically significant difference was observed in the length of stay when comparing the interlaminar approach with the transforaminal approach. Conclusion: The study showed a statistically significant difference in total surgical time, showing shorter operative time for the interlaminar approach. There was no statistically significant difference in the duration of hospital stay. Level of Evidence lV; Comparative Retrospective Study.