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

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.