Ameliorated Full-Endoscopic Transforaminal Decompression for L5-S1 Foraminal and Extraforaminal Stenosis

Abstract

Study design: This is a retrospective review.

Objective: To describe a modified surgical technique, full-endoscopic transforaminal decompression (FETD) in patients with L5-S1 foraminal stenosis or extraforaminal stenosis (EFS) and to detail the short-term results.

Summary of background data: Performing FETD surgery for L5-S1 FS and EFS is challenging because of high iliac crests in most cases and the difficulty in accurately differentiating between FS and EFS by images preoperatively.

Material and methods: Patients who had solitary unilateral L5-S1 FS or EFS and had undergone FETD between October 2014 and December 2017 were included. In total, 22 patients underwent FETD for L5 root compressions at the L5-S1 levels. All patients were followed up for more than 1 year.

Results: The mean visual analog scale score for back and leg pain, assessed preoperatively and at 12 months postoperatively, improved from 6.3±1.7 to 1.59±1.30 and from 7.29±0.78 to 1.41±1.20, respectively. The mean Oswestry Disability Index improved from 61.53% preoperatively to 15.8% at 12 months postoperatively. Neurovascular injury-related complications were absent in all these cases.

Conclusion: Successful short-term clinical outcome is achievable using the ameliorated FETD technique for treating L5-S1 FS and EFS.