Microsurgical Posterolateral Transmuscular Approach for Lumbar Foraminal Stenosis

Abstract

Posterolateral transmuscular approach with microsurgical foraminotomy provided excellent surgical results. Coronal thin-sliced MRI can be useful for diagnosis of this disease.

Comparative observational study of surgical outcomes of lumbar foraminal stenosis using minimally invasive microsurgical extraforaminal decompression alone versus posterior lumbar interbody fusion: a prospective cohort study

“…Inferior partial pediculectomy can be performed to achieve adequate decompression [1][2][3][4][5][6].…”

“…For surgical treatment of lumbar foraminal stenosis (LFS), recent studies have demonstrated the efficacy of microsurgical extraforaminal decompression (MeFD) [1][2][3][4][5][6]. This procedure involves unroofing of the stenotic foramen.…”

“…This procedure involves unroofing of the stenotic foramen. Previous studies have shown very promising surgical outcomes, not only in the short term, but also in long-term follow-up assessments [3][4][5][6]. However, most of these studies were clinical case series, and the surgical outcomes of this decompression technique can worsen over time owing to the progression of degenerative changes in corresponding segments.…”

Lumbar extraforaminal entrapment: performance characteristics of detecting the foraminal spinal angle using oblique coronal MRI. A multicenter study

“…Chang et al [15] also demonstrated that the course became distorted and crank shaped, with the middle section elevated cranially and pushed against the caudal aspect of the pedicle of the cranial vertebra, as observed via coronal MRI. As a morphologic change, this phenomenon might be similar to our findings.…”

“…Moreover, assessing the precise position of the stenosis inside or outside the lumbar spinal canal is important for surgeons, who must choose either extraspinal or intraspinal canal decompression as the appropriate surgical approach [12]. Various methods, such as selective lumbar nerve block [13], electrophysiological methods [14], three-dimensional computed tomography scan [11], and magnetic resonance imaging (MRI) of sagittal sections [1,15], have been suggested to prevent incorrect diagnoses. However, some of these methods can be problematic because of their complexity or lack of sensitivity and specificity (eg, conventional MRI, 93% and 52%, respectively) [16].…”