Transforaminal Endoscopic Lateral Recess Decompression

Transforaminal endoscopic lateral recess decompression (TELRD) for lumbar lateral recess stenosis is an excellent alternative to conventional open surgery. The steep learning curve and lack of a practical manual can make this technique challenging. We describe a step-by-step technique of TELRD based on the literature review and our experience in actual situations, which are as follows: (1) transforaminal endoscopic access on the lateral side of the foraminal window; (2) bony resection of the superior articular process, shoulder osteophyte, and part of the pedicle; and (3) removal of the ligamentum flavum and decompression of the impinged traversing nerve root. In conclusion, this full-endoscopic transforaminal decompression technique may be effective for symptomatic lateral recess syndrome. Primarily, it is helpful for patients at risk of developing general anesthesia complications.