Neurospine.
2019 Mar;16(1):52-62. 10.14245/ns.1938038.019.
Treatment of Soft Tissue and Bony Spinal Stenosis by a Visualized Endoscopic Transforaminal Technique Under Local Anesthesia
- Affiliations
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- 1Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USA.
- 2Desert Institute for Spine Care, Phoenix, AZ, USA.
- 3Department of Orthopedics, First People's Hospital of Wujiang, Affiliated Wujiang Hospital of Nantong University, Suzhou, China.
- 4Department of Spine Surgery, Qilu Hospital, Shandong University, Shandong, China.
- 5Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
- 6Center for Advanced Spine Care of Southern Arizona, Surgical Institute of Tucson, Tucson, AZ, USA. business@tucsonspine.com
- 7Fundación Universitaria Sanitas, Bogotá, D.C., Colombia.
- KMID: 2447810
- DOI: http://doi.org/10.14245/ns.1938038.019
Abstract
OBJECTIVE
To analyze long-term clinical outcomes of endoscopic transforaminal foraminoplasty for foraminal stenosis.
METHODS
Long-term 5-year MacNab outcomes, visual analogue scale (VAS) scores, complications, and unintended aftercare were analyzed in a series of 86 patients who underwent endoscopic transforaminal foraminoplasty for foraminal stenosis.
RESULTS
At minimum 5-year follow-up, excellent results according to the MacNab criteria were obtained in 32 patients (37.2%), Good in 40 (46.5%), fair in 11 (12.8%), and poor in 3 (3.5%), respectively. The mean preoperative VAS was 6.15. The mean postoperative and last follow-up VAS was 3.44. Both postoperative VAS and last follow-up VAS were statistically reduced at a significance level of p<0.0001. Postoperative dysesthesia occurred in 9 patients. Another 9 patients had recurrent disc herniations (10.5%). Failure to cure with persistent pain occurred in 3 patients. Two patients developed pain postoperatively stemming from a different level. One patient experienced a postoperative hematoma which ultimately was inconsequential and did not require any additional surgery. Only 3 patients opted for revision endoscopic discectomy and another 2 for revision fusion surgery.
CONCLUSION
Patients with symptomatic foraminal stenosis may be treated successfully with early transforaminal endoscopic decompression while maintaining favorable long-term outcomes without the need for fusion in the vast majority of patients.
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