Residual bone mass after TLIF treated by TELD under local anesthesia: a case report.

PURPOSE: This paper introduces a postoperative revision technique for transforaminal lumbar interbody fusion, namely, removing a free bone fragment under TELD (transforaminal endoscopic lumbar discectomy) under local anesthesia. It is used to treat the corresponding symptoms caused by the residual bone mass continuously compressing the nerve after transforaminal lumbar interbody fusion. METHODS: Patient with a residual bone fragment after lumbar interbody fusion was treated by removing a free bone fragment under TELD under local anesthesia. RESULTS: A case of a patient who underwent transforaminal lumbar interbody fusion (TLIF) and had a free bone fragment compressing the nerve roots after the operation was successfully treated by removing the free bone fragment under TELD under local anesthesia. After the removal, the patient's symptoms in the right lower limb improved significantly, and the pain and numbness were greatly reduced. During the subsequent four-month follow-up period, the symptoms continued to ease, and there were no other complications. CONCLUSION: The free bone fragment removal under TELD under local anesthesia used in this study is safe and effective, and it can be applied to the treatment of nerve compression caused by the free bone fragment after transforaminal lumbar interbody fusion. We have adopted the AOSpine abbreviation TELD (transforaminal endoscopic lumbar discectomy) and assigned the case to complexity grade IIb (prior surgery + foraminal pathology) per the 2025 two-dimensional classification.