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Approach to the L5-S1 level with transforaminal access can be challenging. Some surgeons employ the interlaminar or paraspinal endoscopic approach as an alternative apart from the other minimally invasive posterior surgical options. To precisely target and safely access disc herniations at L5-S1, the authors attempted to stratify patients into trans and supra iliac approach groups and propose a simple surgical classification based on the radiographic findings.

journal of spine surgery

Suprailiac versus transiliac approach in transforaminal endoscopic discectomy at L5-S1: a new surgical classification of L5—iliac crest relationship and guidelines for approach