PT - JOURNAL ARTICLE AU - Telfeian, Albert E. AU - Ali, Rohaid AU - Konakondla, Sanjay AU - Lewendrowski, Kai-Uwe TI - Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes AID - 10.14444/8763 DP - 2025 May 19 TA - International Journal of Spine Surgery PG - 8763 4099 - https://www.ijssurgery.com/content/early/2025/05/18/8763.short 4100 - https://www.ijssurgery.com/content/early/2025/05/18/8763.full AB - Background This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.Methods Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.Results Out of 183 recipients, 102 patients completed the survey. At the 1-year follow-up, 89.2% of the respondents reported better outcomes in comparison to traditional spine surgeries, and 98% expressed willingness to recommend the procedure to others with similar conditions.Conclusions The findings demonstrate notable advancements in minimally invasive spine surgery, with awake transforaminal endoscopic decompression showing high satisfaction rates tied closely to meeting patient expectations. The study also identifies areas for improvement, particularly in managing postoperative pain and aligning patients’ expectations with clinical results.Clinical Relevance Effective preoperative communication and consistent pain management practices are critical in enhancing patient satisfaction and postoperative recovery, along with the integration of conservative treatments such as physical therapy and acupuncture to maximize surgical outcomes.Level of Evidence 2.