Posterolateral percutaneous endoscopic lumbar foraminotomy for L5—S1 foraminal or lateral exit zone stenosis

Abstract

<jats:p content-type="fine-print">✓ The purpose of this study was to determine the efficacy and feasibility of posterolateral percutaneous endoscopic lumbar foraminotomy (PELF) for foraminal or lateral exit zone stenosis of the L5—S1 level in the awake patient.</jats:p> <jats:p content-type="fine-print">Twelve consecutive patients with L5—S1 foraminal stenosis and associated leg pain underwent PELF between May 2001 and July 2002. Under fluoroscopic guidance, posterolateral endoscopic foraminal decompression was performed using a bone reamer, endoscopic forceps, and a laser. Using this new technique, the authors removed part of the hypertrophied superior facet, thickened ligamentum flavum, and protruded disc compressing the exiting (L-5) nerve root. Clinical outcome was measured using the Macnab criteria. The mean follow-up period was 12.9 months. All the patients were discharged within 24 hours. Satisfactory (excellent or good) results were demonstrated in 10 patients. There was no complication.</jats:p> <jats:p content-type="fine-print">The PELF procedure provides a simple alternative for treating lumbar foraminal or lateral exit zone stenosis in selected cases. The authors found that the posterolateral endoscopic approach to the L5—S1 foramen was usually possible and that using a bone reamer to undercut the superior facet was effective.</jats:p>

Clinical outcomes following sublaminar-trimming laminoplasty for extensive lumbar canal stenosis

“…This approach, which involves adequate decompression of the spinal canal, led to obvious improvement in pain, neurological symptoms, and function 3 years after surgery. These findings are similar to those reported after laminectomy [21] and appear to be better than those associated with minimally invasive foraminotomy [11,12,18]. In our experience, sublaminartrimming laminoplasty allows for sufficient widening of the spinal canal to resolve the symptoms of spinal stenosis.…”

“…Indeed, most patients with extensive lumbar canal stenosis undergo surgery to alleviate symptoms and improve function [7]. Various surgical procedures were described for the treatment of extensive lumbar canal stenosis, including laminectomy, laminotomy, and laminoplasty [9][10][11][12][13][14][15]. Laminectomy is the standard option for surgical decompression of spinal stenosis.…”

Facet Sparing Foraminal Decompression Using the Flexible Shaver Foraminotomy System: Nerve Safety, Pain Relief, and Patient Satisfaction

“…4 A number of techniques exist for foraminal decompression including traditional, endoscopic, and open posterolateral techniques. 5,6 A traditional decompression may create instability in cases of far lateral stenosis, necessitating a fusion. Another option for decompression is a facet-sparing foraminotomy technique using the iO-Flex flexible shaver system (Amendia, Inc., Marietta, Georgia).…”

Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

“…Percutaneous endoscopic lumbar discectomy (PELD) in a transforaminal approach has been validated as a potential alternative to microdiscectomy or open discectomy (Ahn, 2012;Gibson et al, 2012). PELD has numerous advantages over open discectomy, such as the preservation of normal paraspinal structures, minimal postoperative pain, and low risk of epidural scarring and iatrogenic instability (Ahn et al, 2003;Lee D.Y. et al, 2006;2009;.…”