Clinical results of intrapedicular partial pediculectomy for lumbar foraminal stenosis.

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.