TELA (Trans-foraminal Epiduroscopic Laser Annuloplasty)
TELA is a minimally invasive procedure technique for the management of pain
caused by various spinal disorders, wherein physicians utilize a specialized
epidural scope called the NeedleView CH, which is the only one of its
kind worldwide.
Bendable scope
Laser to correct herniated discs or annular tears, etc.
Built-in fiber optics to bring visualization and illumination
Medicine to relieve pain
What are the drawbacks of PELD procedure?
Difficulty to reach into the IVF (e.g. large outer diameter at 8 mm)
Impossible to bend the shaft for making gentle curve
Still larger incision entry
What are the drawbacks of SELD procedure?
Excruciating pain during the procedure
The Sacral Hiatus is sometimes very tiny or even closed (80 % success rate)
Possibility to navigate guide wire or catheter to dorsal epidural space (e.g. very stiff sacral angle)
Poor visualization
Difficulty to reach target lumbar level if there is tough adhesion
Possible nerve injury by forward-firing laser
Long pathway to target lumbar level
Cannot combine discectomy
TELA (Trans-foraminal Epiduroscopic Laser Annuloplasty)
Straight Scope
More horizontal approach >14 cm
Longer scope
Risk of injury to the nerve root or disc
Impossible to approach from posterior (L5-S1)
Bendable Scope
Skin entry < 12 cm off the midline
Shorter scope
Safer and easier access through the IVF
Not difficult to approach the ventral epidural space through the IVF, even at L5-S1