Full-Endoscopic Transforaminal Decompression with Modified Reaming Technique on Lateral Recess Stenosis: Outcomes of 155 Cases and Five Years’ Experience. A Case Series Study

Abstract

Objective

Lateral recess stenosis (LRS) is a degenerative condition which caused by bulging disc, hyperplasia of superior articular process and hypertrophy of ligament flavum. The advancement of transforaminal endoscopic lumbar approaches provides effective treatment not only for migrated herniation but also for stenosis. We outlined a modified non-sequential foraminoplasty technique utilizing a trephine, and conducted a comprehensive review of our cases to demonstrate safety and efficacy of the procedure.

Methods

Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with magnetic resonance imaging (MRI) and diagnostic root blocks, and underwent full endoscopic transforaminal decompression with the modified non-sequential foraminoplasty technique between April 2017 to September 2022 were included. Those with multiple level stenosis, previous surgery at the same level, unstable spondylolisthesis, lumbar herniated disc without stenosis, infection, fracture, or tumor were excluded. The study recorded the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Modified Macnab criteria, as well as intra- and postoperative complications.

Results

. 155 patients were included in the study. Clinical and postoperative outcomes revealed significantly lower back and leg visual analog scale scores, as well as Oswestry Disability Index scores at various postoperative time points compared to preoperative values (P

Conclusions

Full endoscopic transforaminal decompression using modified non-sequential foraminoplasty technique is an effective and safe treatment for lumbar lateral recess stenosis.