The endoscope provides direct visualization through the transforaminal working channel, allowing the surgeon to identify and decompress neural structures while limiting the amount of tissue disruption. This visualization supports the sequence of disc removal, endplate preparation, graft placement, and cage insertion. The muscle-sparing access is intended to preserve surrounding tissues while addressing the symptomatic motion segment.
Disc removal clears the intervertebral space, while endplate preparation creates the treated surfaces needed for placement of bone graft and an interbody cage. Together, these steps support reconstruction of the lumbar motion segment after decompression. Their role is distinct from neural decompression: they address the disc space and stabilization component rather than only relieving pressure on neural structures.
The interbody cage and bone graft occupy the prepared disc space as part of the fusion construct. Percutaneous pedicle-screw fixation may be added to reinforce stabilization of the treated segment. These components address different parts of the procedure: the cage and graft are placed within the interbody space, whereas the screws provide additional fixation across the lumbar segment.
Fe-TLIF uses a full-endoscopic, transforaminal working channel and a muscle-sparing access strategy rather than relying on broader tissue exposure. The approach combines direct visualization with decompression, disc-space preparation, and implant placement. Its intended advantages are reduced tissue disruption and support for postoperative recovery, while still addressing neural compression and segmental instability.
The procedure progresses through several linked stages: accessing the lumbar segment through a transforaminal channel, decompressing neural structures, removing the intervertebral disc, preparing the endplates, and placing bone graft with an interbody cage. When indicated, the construct also includes percutaneous pedicle-screw fixation. This sequence combines symptom-directed decompression with reconstruction and stabilization of the motion segment.
Fe-TLIF may be considered for selected patients with degenerative disc disease, foraminal stenosis, spondylolisthesis, or segmental instability. The procedure is therefore relevant when both neural compression or painful degeneration and a need for stabilization are present. The overview emphasizes selection, so the named diagnosis alone does not establish that the procedure is appropriate for every patient.