The structured narrative synthesis and survey of 172 spine surgeons found no universal superiority. Twelve of 25 scenarios reached consensus, with approach preferences varying by lesion location and anatomy.
Key findings
- No approach is universally superior
- TELD is favored for selected foraminal/extraforaminal lesions
- IELD is favored for central/paracentral L5–S1 and selected migrated lesions
Why this matters globally
The findings reinforce anatomy-driven rather than platform-driven approach selection.
Thai researcher contribution
Thai contributors included researchers from Rayong Hospital, Chulalongkorn University, Chiang Mai University and King Chulalongkorn Memorial Hospital, including corresponding authors.
Limitations to consider
The evidence synthesis was nonsystematic, and many clinical scenarios did not reach the consensus threshold.