Comparison of efficacy between transforaminal and interlaminar endoscopic discectomy for single-level lumbar disc herniation

This retrospective study compared the efficacy of transforaminal endoscopic lumbar discectomy (TELD) and interlaminar endoscopic lumbar discectomy (IELD) for single-level L4-L5 lumbar disc herniation. A total of 208 patients were included, with 101 undergoing TELD and 107 undergoing IELD between August 2022 and August 2024. Baseline demographic and clinical characteristics were comparable between groups. Perioperative analysis showed that TELD required a longer operative time and more intraoperative fluoroscopic exposures than IELD, whereas hospital stay and complication rates were similar. At 12-month follow-up, both techniques achieved significant improvements in visual analogue scale and Oswestry disability index scores relative to baseline. However, IELD yielded lower residual pain and better functional recovery, reflected by significantly lower final visual analogue scale and Oswestry disability index scores compared with TELD. These findings suggest that both procedures are safe and effective for L4-L5 lumbar disc herniation, but IELD may provide greater surgical efficiency and superior long-term functional outcomes, emphasizing the importance of anatomy-guided approach selection.