TELD with limited foraminoplasty has potential biomechanical advantages over TELD with large annuloplasty: an in-silico study

Abstract Background Facetectomy, an important procedure in the in–out and out–in techniques of transforaminal endoscopic lumbar discectomy (TELD), is related to deterioration postoperative biomechanical environment poor prognosis. Facetectomy may be avoided TELD with large annuloplasty, but iatrogenic injury annulus a high grade nucleotomy have been reported as risk factors influencing These alleviated limited foraminoplasty, facetectomy this surgery can reduced by using dynamic drill. Methods An intact lumbo-sacral finite element (FE) model corresponding adjacent segment degeneration were constructed validated evaluate complications annuloplasty foraminoplasty. Changes various indicators then computed surgical segment. Results Compared FE models, foraminoplasty demonstrated slight deterioration, whereas revealed obvious deterioration. Degenerative changes segments magnified, rather than altered, overall trends change. Conclusions presents potential advantages over annuloplasty. Iatrogenic are for