Objectives The purpose of this study was to retrospectively compare the efficacy and safety of visualized reamer foraminoplasty vs. the traditional TESSYS technique in transforaminal endoscopic lumbar discectomy (TELD) for lumbar disc herniation (LDH). Methods In this retrospective study, 140 LDH patients were assigned to the visualized reamer group ( n = 70) or the TESSYS group ( n = 70). Perioperative parameters (operative time, fluoroscopy frequency), clinical outcomes Visual Analog Score (VAS) for back/leg pain, Oswestry Disability Index (ODI) were assessed preoperatively and at 1 day, 1, 3, 6, and 12 months postoperatively. Peri-operative complications were recorded. Subgroup analyses were performed. Results The visualized reamer group demonstrated significant advantages in operative time (66.34 ± 7.65 vs. 76.06 ± 15.89 min, P 0.05) and intraoperative fluoroscopy frequency (6.10 ± 0.90 vs. 12.06 ± 0.92, P 0.05). Both groups showed significant clinical improvement at all timepoints ( P 0.05). The visualized reamer group demonstrated superior early postoperative leg pain relief, evidenced by significantly lower VAS leg scores at 1 day (mean difference: −0.64 points) and 1 month (mean difference: −0.43 points) compared to the TESSYS group (both P 0.05). Mid-term clinical outcomes were comparable between the two groups. Complication analysis revealed a significantly lower incidence of postoperative lower limb dysesthesia in the visualized reamer group (0% vs. 5.71%, P 0.05), while recurrence rates showed no significant difference (1.43% vs. 2.86%, P 0.05). Subgroup analyses confirmed consistent treatment benefits across age, BMI, and sex ( P 0.05). Conclusion The visualized reamer technique significantly enhances perioperative efficiency and early pain control in TELD, with comparable mid-term efficacy to the TESSYS technique. Its benefits are consistent across diverse patient populations, supporting its broad applicability.
Liu et al. (Wed,) studied this question.