Extraforaminal Full-Endoscopic Approach for the Treatment of Lateral Compressive Diseases of the Lumbar Spine

Abstract

Background: The authors conducted a 2-year retrospective follow-up to investigate the efficiency of an extraforaminal full-endoscopic approach with foraminoplasty used to treat lateral compressive diseases of the lumbar spine in 247 patients. Methods: The visual analogue scale (VAS), Oswestry disability index (ODI), and MacNab scale were used to analyze the results collected during the preoperative and postoperative periods. Results: The most common diagnosis was disk herniation with lateral recess stenosis, and the most common surgical level among patients was between L4 and L5 on the left side. Pain decreased over time, as determined during sessions held to evaluate pain in the lumbar, gluteal, led, and foot regions. The ODI demonstrated significant enhancement over the evaluation period and the MacNab scale classified the surgery as good or excellent. The most common complication was dysesthesia. Conclusions: An extraforaminal full-endoscopic approach with foraminoplasty can be recommended in cases of lateral herniation or stenosis for patients with symptoms of radiculopathy, and for those who have not responded to conventional rehabilitation treatment or chronic pain management. Few complications arose as a result of this approach, and most of them were treated clinically.

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note

“…Table 1 provides parameters for satisfactory contralateral decompression according to Bergamaschi et al [33]. [33].…”

“…Radiological parameters are confirmed by radioscopy and include decompression at the superomedial border of the contralateral caudal pedicle and decompression at the inferomedial border of the contralateral cranial pedicle, according to Table 1. Table 1 provides parameters for satisfactory contralateral decompression according to Bergamaschi et al [33]. Posterior cervical over-the-top decompression, as described, allows for satisfactory decompression in postoperative examinations (Figure 4).…”

Nerve Root Herniation With Entrapment After Endoscopic Spine Decompression

“…ner and outer membranes), it is prone to tear [4]. Especially when performing an endoscopic spine surgery, endoscopic repair of dura tear is challenging for spine surgeons because of its limited operative field [5]. Several articles have introduced management of dura tear using an autologous muscle graft or fibrin-sealed collagen sponge after endoscopic lumbar surgery including studies of Müller et al [1] and Oertel and Burkhardt [6].…”

Development of Indications for Endoscopic Spine Surgery: An Overview

“…With the advent of foraminoplasty in the TF approach, it was possible to remove central disc herniations and perform decompression of the lateral recess and foramen in the lumbar or thoracic spine [11]. In 1997, Osman published a cadaveric study in which the TF technique resulted in less instability and greater expansion of the foraminal space [12].…”