Iatrogenic contralateral foraminal stenosis following lumbar spine fusion surgery: illustrative cases

Abstract

BACKGROUND Lumbar spine fusion is the mainstay treatment for degenerative spine disease. Multiple potential complications of spinal fusion have been found. Acute contralateral radiculopathy postoperatively has been reported in previous literature, with unclear underlying pathology. Few articles reported the incidence of contralateral iatrogenic foraminal stenosis after lumbar fusion surgery. The aim of current article is to explore the possible causes and prevention of this complication. OBSERVATIONS The authors present 4 cases in which patients developed acute postoperative contralateral radiculopathy requiring revision surgery. In addition, we present a fourth case in which preventive measures have been applied. The aim of this article was to explore the possible causes and prevention to this complication. LESSONS Iatrogenic foraminal stenosis of the lumbar spine is a common complication; preoperative evaluation and middle intervertebral cage positioning are needed to prevent this complication.

Uniportal Full‐endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Clinical Characteristics and Functional Outcomes

“…The condition typically arises as a consequence of age‐related changes in the spine, leading to narrowing of the neural foramen and potential compression of nerve roots in the lumbar region. It occurs more frequently at L4‐L5 and L5‐S1 and is caused by loss of foraminal height, foraminal disc herniation, osteophytes and/or ligament flavum, and hypertrophied facet articular processes 1,2 . LFS constitutes a significant pathological condition leading to lumbar radiculopathies, comprising around 8%–11% of lumbar degenerative diseases necessitating surgical interventions.…”