Endoscopic laser foraminoplasty provides a minimalist means of exploring the extraforaminal zone, the foramen, the disc, and the epidural space and performing discectomy, lateral recess decompression, osteophytectomy, and neural mobilization. Performed in the aware state, it serves to identify and localize precisely the causal source of pain in multilevel disc disease, in revision surgery, and in the infirm and elderly without open fusion or decompression.

The sustained nature of the benefit (mean 3.5 years at final follow up) after long-term preoperative symptoms (mean 3.9 years) in 76% patients rules out placebo effect. Benefits occurred independently of the wavelength of laser used.

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