Inside-Out Technique of Transforaminal Full-Endoscopic Lumbar Discectomy (TELD)

  • Fumitake Tezuka


The inside-out technique of transforaminal full-endoscopic lumbar discectomy is a traditional technique, which was developed from percutaneous nucleotomy by Hijikata. Transforaminal approach can be done under local anesthesia, and there are great benefits. During the surgery, patients would be in awake and aware condition; thus, severe nerve root injury can be avoided. The surgical technique is easy to adopt by beginners compared to outside-in technique. However, it has some issues which we should pay attention to during surgery. If there would be exiting nerve root irritation when approaching to the disc, it is important not to hesitate to change for outside-in technique.


TELD Local anesthesia Discogram Inside-out Half and half view 


  1. 1.
    Sairyo K, Egawa H, Matsuura T, et al. State of the art: transforaminal approach for percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Invest. 2014;61(3–4):217–25.CrossRefGoogle Scholar
  2. 2.
    Kambin P, Schaffer JL. Percutaneous lumbar discectomy. Review of 100 patients and current practice. Clin Orthop Relat Res. 1989;238:23–34.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2021

Authors and Affiliations

  • Fumitake Tezuka
    • 1
  1. 1.Department of OrthopedicsTokushima UniversityTokushimaJapan

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