Application of percutaneous foraminotomy with a specially designed drill tip for foraminal stenosis patient - A case report -

Abstract

Degenerative diseases are rapidly increasing all over the world with the increase of the elderly population.Spinal stenosis is one of the common degenerative disease and various treatment methods have been applied to treat this disease and control the pain. Currently, diverse, non-operative interventions used for the treatment of spinal stenosis in addition to novel interventional techniques and tools are rapidly [1].These interventions are alternative methods to patients who are not responsive to conservative treatment like physical therapy, medications and epidural steroid injections. Furthermore, these can be useful treatment options to patients who refuse surgery.Leg pain while walking, which is relieved when the patient squats, sits, or rests, is a typical symptom of foraminal stenosis. This suggests that the pressure on the nerve root is an important factor of disease pathogenesis and that foraminal decompression is central to the treatment of foraminal steno-The purpose of this report is to introduce a new therapeutic intervention for foraminal stenosis-percutaneous foraminotomy with the use of the Claudicare system. Percutaneous foraminotomy is a procedure that indirectly decompresses the foramen, and is performed in the safe area inside the neural foramen, which is Kambin's triangle. CASE REPORTA 77-year-old 164 cm, 62 kg previously healthy Asian man This case report describes a new method of pain management intervention: percutaneous foraminotomy using the Claudicare system (Seawon Meditech, Korea). In this case, a 77-year-old Asian man visited the hospital with motor weakness in his left foot. He was diagnosed with L4-5 grade three foraminal stenosis using Magnetic Resonance Imaging on both sides. A left L4-5 foraminal decompression was performed using percutaneous foraminotomy. The patient revisited the hospital after 17 months because the same symptoms recurred in his right foot. We observed that the symptoms on the left foot had disappeared completely. We confirmed the lesion on the right side and the postoperative change on the left side on the magnetic resonance imaging (MRI) image. Both the pre-and postoperative MRI images were compared by measuring the dimensions of the foraminal area (28.12 mm 2 vs. 38.58 mm 2 , repectively). T1W images showed signs of increased epidural soft tissue after percutaneous foraminotomy.