ORIGINAL
Introdução: A discectomia lombar endoscópica transforaminal (TELD) é uma alternativa minimamente invasiva para hérnia de disco lombar, embora dados brasileiros sejam limitados. Objetivo: Avaliar o alívio da dor, a morbidade perioperatória e os desfechos clínicos após TELD. Métodos: Estudo retrospectivo com 55 adultos submetidos à TELD em um centro brasileiro entre maio de 2021 e outubro de 2025. Foram avaliados escores de dor pela Escala Visual Analógica (EVA), parestesia, alterações simpáticas, hematoma epidural, infecção, reoperação, lesão do saco dural ou da raiz nervosa, tempo operatório e perda sanguínea estimada. Resultados: A idade média foi de 49,5 anos, e a maioria dos procedimentos envolveu um nível em L4–L5. Não ocorreram lesões do saco dural ou da raiz nervosa. O tempo operatório médio foi de 97,0 minutos, e a perda sanguínea média foi de 14,54 mL. A EVA diminuiu de 9,38 para 3,94 (p < 0,0001). Parestesia ocorreu em 14 pacientes (25,5%) e regrediu espontaneamente. Houve um hematoma epidural sem necessidade de drenagem. Não ocorreram infecções, alterações simpáticas ou reoperações. Conclusão: A TELD proporcionou alívio significativo da dor, com baixa morbidade perioperatória
Introduction: Transforaminal endoscopic lumbar discectomy (TELD) is a minimally invasive treatment for lumbar disc herniation, although Brazilian data remain limited. Objective: To evaluate pain relief, perioperative morbidity, and clinical outcomes after TELD. Methods: This retrospective study included 55 adults who underwent TELD at a single Brazilian center between May 2021 and October 2025. Outcomes included Visual Analog Scale (VAS) pain scores, paresthesia, sympathetic changes, epidural hematoma, infection, reoperation, dural sac or nerve root injury, operative time, and estimated blood loss. Results: Mean age was 49.5 years, and most procedures involved a single level at L4–L5. No dural sac or nerve root injuries occurred. Mean operative time was 97.0 minutes, and mean estimated blood loss was 14.54 mL. Mean VAS score decreased from 9.38 preoperatively to 3.94 postoperatively (p < 0.0001). Paresthesia occurred in 14 patients (25.5%) and resolved spontaneously during follow-up. One epidural hematoma occurred without requiring drainage. No infections, sympathetic changes, or reoperations were recorded. Conclusion: TELD provided significant pain relief with low perioperative morbidity and was a safe, effective minimally invasive treatment for lumbar disc herniation.
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1Instituto do Cérebro, Fundação de Neurologia e Neurocirurgia, Salvador, BA, Brazil.
2Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
Received Mar 25, 2026
Accepted May 7, 2026
