Five-Year Outcomes of Transforaminal Endoscopic Lumbar Decompression for Lateral Recess Stenosis in Patients With Chronic Systemic Disease

BACKGROUND: Transforaminal endoscopic lumbar decompression (TELD) has emerged as a minimally invasive treatment for lumbar lateral recess stenosis (LRS). However, long-term outcomes in patients with chronic systemic disease remain insufficiently characterized. OBJECTIVE: To evaluate the clinical outcomes and safety of TELD in patients with chronic systemic disease undergoing surgery for symptomatic single-level lumbar LRS. METHODS: This retrospective observational study included patients with chronic systemic disease who underwent TELD with reamed foraminoplasty for symptomatic single-level lumbar LRS at a single tertiary spine center between January 2016 and March 2021. Clinical outcomes were assessed using visual analog scale (VAS) scores for leg and back pain, the Oswestry Disability Index, and modified MacNab criteria. Follow-up was conducted for 60 months. Early complications (≤30 days) and reoperations were recorded. RESULTS: < 0.001). According to the modified MacNab criteria, 85.1% of patients achieved excellent or good outcomes. Early complications occurred in 3 patients (4.5%), all consisting of transient postoperative dysesthesia, while late reoperation was required in 4 patients (6.0%). CONCLUSIONS: TELD resulted in significant and durable improvements in pain and functional disability over a 5-year follow-up period in patients with chronic systemic disease. These findings support TELD as a safe and effective minimally invasive treatment option for carefully selected patients with chronic systemic disease and lumbar LRS. CLINICAL RELEVANCE: This study highlights TELD as a viable minimally invasive treatment option for patients with chronic systemic disease, offering durable symptom relief in a carefully selected cohort.