Strategies to Reduce Rebound Pain and Facilitate Early Recovery After Transforaminal Endoscopic Lumbar Discectomy.

Background

Transforaminal endoscopic lumbar discectomy (TELD) is a minimally invasive and popular surgical method for the treatment of lumbar disc herniation. Although TELD offers favourable outcomes and enables fast recovery, some patients experience rebound pain and transient postoperative pain, which can delay rehabilitation and decrease patient satisfaction.

Methods

This narrative review was conducted based on a comprehensive literature search of the MEDLINE database, supplemented by the author's clinical experience. Relevant articles were identified using the keywords "rebound pain" and "transforaminal endoscopic lumbar discectomy" or "percutaneous endoscopic lumbar discectomy". A thorough examination of rebound pain after TELD was performed by reviewing what has currently been published about its clinical traits. It was also compared with what could be observed in open lumbar discectomy and proposed preventive measures.

Results

Rebound pain typically occurs within 2 weeks postoperatively and resolves spontaneously within 3 weeks. The proposed pathologies include inflammatory edema, transient ischemia, neural hypersensitivity, and increased pressure inside the disc. Risk factors include early unreasonable activity, incomplete release, and psychological predispositions. Rebound pain must be distinguished from recurrent herniation. Prevention strategies include adequate decompression, minimal neural irritation, postoperative medications, and early mobilization protocols.

Conclusions

Rebound pain after TELD is self-limiting but has a clinical effect that may delay timely rehabilitation and raise concerns for surgeons and patients. Awareness and early recognition can enhance postoperative care and optimize clinical outcomes after TELD.