Clinical results of intrapedicular partial pediculectomy for lumbar foraminal stenosis

J Spinal Disord Tech. 2008 Jul;21(5):324-7. doi: 10.1097/BSD.0b013e318149e681.

Abstract

Design: A retrospective case study of the use of intrapedicular partial pediculectomy (IPPP) to treat lumbar foraminal stenosis.

Objective: To evaluate the clinical results of lumbar foraminal stenosis treated with IPPP.

Summary of background data: There is no gold standard for the surgical treatment of foraminal stenosis, which occurs in 8% of surgical cases of lumbar degenerative diseases.

Methods: A total of 26 patients who were followed up for a minimum of 2 years after IPPP for foraminal stenosis, were included in this study. The study group consisted of 20 men and 6 women with an average age at surgery of 63.3 years (range: 42 to 83) and a mean follow-up of 5.5 years (range: 2 to 11). The affected levels were L3/4 in 1 patient, L4/5 in 7, and L5/S1 in 18. Bilateral IPPP at L5/S1 was performed in 2 patients. The clinical results were evaluated according to the Japanese Orthopedic Association (JOA) scoring system.

Results: Two patients required revision surgery to correct insufficient decompression. In the remaining 24 patients, the average JOA scores were 6.7 (range: -1 to 10) before surgery, 12.4 (range: 9 to 15) 3 months after surgery, 12.3 (range: 9 to 15) 1 year after surgery, and 11.7 (range: 5 to 15) at the final follow-up. The average recovery rate was 62.1% (range: 40.0% to 81.3%).

Conclusions: This follow-up study confirms that IPPP affords long-lasting improvements in leg symptoms for patients with lumbar foraminal stenosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Decompression, Surgical / instrumentation
  • Decompression, Surgical / methods*
  • Female
  • Humans
  • Laminectomy / instrumentation
  • Laminectomy / methods*
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology
  • Low Back Pain / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Sciatic Neuropathy / etiology
  • Sciatic Neuropathy / physiopathology
  • Sciatic Neuropathy / surgery
  • Spinal Nerve Roots / injuries
  • Spinal Nerve Roots / physiopathology
  • Spinal Nerve Roots / surgery
  • Spinal Stenosis / pathology
  • Spinal Stenosis / physiopathology
  • Spinal Stenosis / surgery*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Zygapophyseal Joint / pathology
  • Zygapophyseal Joint / physiopathology
  • Zygapophyseal Joint / surgery*