Clinical and radiological outcomes of endoscopic partial facetectomy for degenerative lumbar foraminal stenosis

• Published in: Acta neurochirurgica Vol. 159; no. 6; pp. 1129 - 1135
• Main Authors: Youn, Myung Soo, Shin, Jong Ki, Goh, Tae Sik, Lee, Jung Sub
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.06.2017; Springer Nature B.V
• Subjects: Adult; Aged; Constriction, Pathologic; Decompression; Decompression, Surgical - adverse effects; Decompression, Surgical - methods; Degenerative disc disease; Diskectomy - adverse effects; Diskectomy - methods; Endoscopy; Female; Humans; Interventional Radiology; Intervertebral Disc Degeneration - diagnostic imaging; Intervertebral Disc Degeneration - surgery; Intervertebral discs; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Lumbar Vertebrae - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neuroendoscopy - adverse effects; Neuroendoscopy - methods; Neurology; Neuroradiology; Neurosurgery; Original Article - Spine; Postoperative Complications - diagnostic imaging; Postoperative Complications - epidemiology; Radiography; Stenosis; Surgery; Surgical Orthopedics; Foraminal stenosis; Degenerative; Lumbar; Facetectomy; Endoscopic
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-017-3186-0

Background Several different techniques exist to treat degenerative lumbar foraminal stenosis. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, wide decompression often causes spinal instabilities or may require an additional fusion surgery. The aim of this study was to report the outcomes of endoscopic partial facetectomy (EPF) performed on patients with degenerative lumbar foraminal stenosis. Methods Between 2012 and 2014, 25 consecutive patients (12 women and 13 men) who underwent EPF were included in the study. The patients were assessed before surgery and followed-up regularly during outpatient visits (preoperatively and 1, 3, 6, 12, and 24 months postoperatively). The clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) outcome questionnaire. The radiological outcome was measured using the lumbar Cobb angle, disc wedging angle, lumbar lordosis (LL), slip percentage, and disc height index (DHI) in plain standing radiographs. Results The VAS, ODI, and SF-36 scores significantly improved at 1 month of follow-up compared with the baseline mean values and were maintained within the 2-year follow-up period. There was no radiologic progression in the lumbar Cobb’s angle, disc wedging angle, LL, slip percentage, and DHI between preoperatively and 2 years postoperatively. In addition, the EPF with discectomy group and the EPF group were not significantly different in terms of clinical and radiological outcomes. Conclusions EPF is an effective option in decompressing the lumbar exiting nerve root without causing spinal instabilities for the treatment of patients with lumbar foraminal stenosis.