Transforaminal 360° lumbar endoscopic foraminotomy in postfusion patients: technical note and case series

View More View Less
  • 1 Department of Neurosurgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital;
  • | 2 Division of Applied Mathematics, Brown University; and
  • | 3 Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $376.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
Print or Print + Online

OBJECTIVE

This report describes a minimally invasive lumbar foraminotomy technique that can be applied in patients who underwent complex spine decompression procedures or in patients with severe foraminal stenosis.

METHODS

Awake, endoscopic decompression surgery was performed in 538 patients over a 5-year period between 2014 and 2019. Transforaminal endoscopic foraminal decompression surgery using a high-speed endoscopic drill was performed in 34 patients who had previously undergone fusions at the treated level.

RESULTS

At 2-year follow-up, the mean (± SD) preoperative visual analog scale score for leg pain and the Oswestry Disability Index improved from 7.1 (± 1.5) and 40.1% (± 12.1%) to 2.1 (± 1.9) and 13.6% (± 11.1%).

CONCLUSIONS

A minimally invasive, awake procedure is presented for the treatment of severe lumbar foraminal stenosis in patients with lumbar radiculopathy after lumbar fusion.

ABBREVIATIONS

AP = anteroposterior; LLIF = lateral lumbar interbody fusion; ODI = Oswestry Disability Index; SAP = superior articulating process; TLIF = transforaminal lumbar interbody fusion; VAS = visual analog scale.

Illustrations from Hubbe et al. (pp 160–163). Copyright Ioannis Vasilikos and Roberto Ferrarese. Published with permission.

Spine - 1 year subscription bundle (Individuals Only)

USD  $376.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
  • 1

    Ciol MA, Deyo RA, Kreuter W, Bigos SJ. Characteristics in Medicare beneficiaries associated with reoperation after lumbar spine surgery. Spine (Phila Pa 1976). 1994;19(12):13291334.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2

    Hu RW, Jaglal S, Axcell T, Anderson G. A population-based study of reoperations after back surgery. Spine (Phila Pa 1976). 1997;22(19):22652271.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3

    Martin BI, Mirza SK, Comstock BA, et al. Reoperation rates following lumbar spine surgery and the influence of spinal fusion procedures. Spine (Phila Pa 1976). 2007;32(3):382387.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4

    Hazard RG. Failed back surgery syndrome: surgical and nonsurgical approaches. Clin Orthop Relat Res. 2006;443(443):228232.

  • 5

    Safaee MM, Tenorio A, Haddad AF, et al. Anterior lumbar interbody fusion with cage retrieval for the treatment of pseudarthrosis after transforaminal lumbar interbody fusion: a single-institution case series. Oper Neurosurg (Hagerstown). 2021;20(2):164173.

    • Search Google Scholar
    • Export Citation
  • 6

    Jung J, Lee S, Cho DC, et al. Usefulness of oblique lumbar interbody fusion as revision surgery: Comparison of clinical and radiological outcomes between primary and revision surgeries. World Neurosurg. 2021;149:e1067e1076.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Park D, Mummaneni PV, Mehra R, et al. Predictors of the need for laminectomy after indirect decompression via initial anterior or lateral lumbar interbody fusion. J Neurosurg Spine. 2020;32(6):781787.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8

    Ragab A, Deshazo RD. Management of back pain in patients with previous back surgery. Am J Med. 2008;121(4):272278.

  • 9

    Arts MP, Kols NI, Onderwater SM, Peul WC. Clinical outcome of instrumented fusion for the treatment of failed back surgery syndrome: a case series of 100 patients. Acta Neurochir (Wien). 2012;154(7):12131217.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10

    Ahn J, Tabaraee E, Bohl DD, et al. Primary versus revision single-level minimally invasive lumbar discectomy: analysis of clinical outcomes and narcotic utilization. Spine (Phila Pa 1976). 2015;40(18):E1025E1030.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11

    Hentenaar B, Spoor AB, de Waal Malefijt J, et al. Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery. J Orthop Surg Res. 2016;11:2.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Selznick LA, Shamji MF, Isaacs RE. Minimally invasive interbody fusion for revision lumbar surgery: technical feasibility and safety. J Spinal Disord Tech. 2009;22(3):207213.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Kang MS, Park JY, Kim KH, et al. Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation: comparison between primary and revision surgery. BioMed Res Int. 2014;2014:919248.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Telfeian AE, Oyelese A, Fridley J, Gokaslan ZL. Transforaminal endoscopic surgical treatment for posterior migration of polyetheretherketone transforaminal lumbar interbody fusion cage: case series. World Neurosurg. 2021;147:e437e443.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Telfeian AE, Moldovan K, Shaaya E, et al. Awake, endoscopic revision surgery for lumbar pseudarthrosis after transforaminal lumbar interbody fusion: technical notes. World Neurosurg. 2020;136:117121.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Sairyo K, Katoh S, Sakamaki T, et al. A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Technical note. J Neurosurg. 2003;98(3)(suppl):290293.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Hijikata S. Percutaneous nucleotomy. A new concept technique and 12 years’ experience. Clin Orthop Relat Res. 1989;(238):923.

  • 18

    Kambin P, Schaffer JL. Percutaneous lumbar discectomy. Review of 100 patients and current practice. Clin Orthop Relat Res. 1989;(238):2434.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19

    Schreiber A, Leu H. Percutaneous nucleotomy: technique with discoscopy. Orthopedics. 1991;14(4):439444.

  • 20

    Yeung AT. The evolution of percutaneous spinal endoscopy and discectomy: state of the art. Mt Sinai J Med. 2000;67(4):327332.

  • 21

    Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976). 2002;27(7):722731.

    • Crossref
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 156 156 156
Full Text Views 53 53 53
PDF Downloads 73 73 73
EPUB Downloads 0 0 0