Abstract
Transforaminal endoscopic lumbar decompression (TELD) has evolved significantly since Kambin's first description of the triangular working zone (Kambin's triangle) in 1983. Over four decades, numerous surgical techniques have been developed, each employing distinct terminology to describe the removal of bone from the facet joint (specifically the superior articular process, SAP) to access neural structures. These terms include "foraminoplasty," "foraminotomy," "facetectomy," and various trademarked designations (TESSYS, YESS, FEVFD, UBiSES, ZESSYS, Maxmore, etc.). A critical gap exists in the current literature: while multiple classification systems and geometric models have been proposed (Lee's three zones [1988], Kambin's triangle [1983], Schizas grading [2010], Wang three-type classification [2019], Kambin's Prism [Tumialan 2019], and the Four-Quadrant Facet Remodeling [4Q-FRM, Chen et al., submitted]), no comprehensive review has mapped the conceptual evolution of facet resection boundaries from the first description to the present day. Furthermore, significant terminological inconsistencies exist: the same term ("foraminoplasty") may refer to removal of 2 mm of SAP tip or resection of the entire facet complex, and different terms may describe identical operations. This scoping review aims to systematically map the evolution of facet resection boundary concepts in TELD, identify terminological inconsistencies and their clinical implications, and assess the convergent or divergent evidence from anatomical, biomechanical, and clinical studies regarding a unified geometric coordinate framework for facet resection.
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