We conducted a systematic review and meta-analysis of endoscopic foraminotomy (TELF) outcomes in the treatment of lumbar foraminal stenosis consequent to bony stenosis or lateral disc herniation.

We abstracted TELF outcomes and complications even in patients with failed back surgery syndrome (FBSS), degenerative spinal conditions (i.e., adjacent level degeneration), or who developed foraminal stenosis after fusion or fixation surgery.

Multiple databases were searched for studies published in English involving patients > 18 years old who underwent endoscopic lumbar foraminotomy.

Our analysis estimated overall outcomes and adverse event rates and did not find significant differences in satisfactory outcomes or adverse events between the analyzed groups, except for higher rates of transient leg sensory disturbances in patients with previous surgery or with FBSS.

TELF results in terms of patients satisfaction (85%), improvement of disability, and radiculopathy with pain are comparable to those of traditional mini-invasive or open procedures, with almost negligible adverse events rates.

Our study confirms the feasibility and safety of transforaminal endoscopic lumbar foraminotomy in a wide range of spine conditions, thus expanding the application of endoscopic techniques in spine surgery.