Comparison of Full Endoscopic Lumbar Diskectomy Using the Transforaminal Approach versus Interlaminar Approach for L5–S1 Lumbar Disk Herniation Treatment: A Meta-Analysis

Abstract

Objective: Numerous studies have examined the clinical effectiveness of transforaminal and interlaminar full endoscopic lumbar discectomy (T-FELD and I-FELD) for L5-S1 lumbar disc herniation (LDH), with mixed findings. The goal of this systematic review and meta-analysis was to evaluate the perioperative outcomes, clinical results, and complications of T-FELD and I-FELD to determine their efficacy and safety for treating L5-S1 LDH and to examine the features of complications in depth. Methods: Several databases were searched for papers that matched all of the inclusion criteria. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were used to assess the clinical results. Information on perioperative outcomes and complications was gathered and analyzed. Results: Eight studies with 756 participants were included. There were no significant differences in postoperative bed time (P = 0.44) and hospitalization time (P = 0.49) between T-FELD and I-FELD. When compared with I-FELD, T-FELD was associated with substantially longer fluoroscopy time (P < 0.0001) and operating time (P < 0.0001). There were no significant differences in the preoperative and postoperative VAS and ODI scores between T-FELD and I-FELD. The complication rates for overall complications, postoperative dysesthesia, postoperative lower extremity pain, incomplete decompression, recurrence, and conversion to open surgery were comparable for T-FLED and I-FELD in the treatment of L5-S1 LDH. Conclusion: T-FELD and I-FELD had equal clinical results and safety for treatment of L5-S1 LDH. Fluoroscopy times and operative times were shorter for I-FELD than T-FELD.