Comparative Study of the Differences in Radiologic Results for Percutaneous Endoscopic Lumbar Foraminotomy and Microscopic or Micro-endoscopic Lumbar Foraminotomy

Abstract

Objective Lumbar foraminal stenosis is a common pathology that causes back pain and radiculopathy. Percutaneous endoscopic lumbar foraminotomy (PELF) is a minimally invasive surgical procedure reported to be effective in the treatment of foraminal stenosis; however, no studies have been conducted that compare the on radiographic results of PELF and conventional techniques for the treatment of foraminal stenosis, such as microscopic foraminotomy and micro-endoscopic foraminotomy. This study aimed to report postoperative changes in the lumbar foraminal parameters on computed tomography (CT) after PELF and to compare the radiological efficacy of the PELF technique with that of the conventional techniques. Methods Radiographic evaluation of the neuroforamen was based on CT scans taken preoperatively and 3 months postoperatively in the PELF and conventional groups. The Japanese Orthopaedic Association (JOA) score for back pain, visual analog scale (VAS), and JOA back pain evaluation questionnaire (JOABPEQ) were evaluated preoperatively and at 3 months postoperatively in the PELF group. Results The PELF and conventional groups comprised 21 and 17 patients, respectively. In the PELF group, the JOA score, VAS of back pain, and JOABPEQ of low back pain showed significant improvement. There were significant increases in the foraminal area, superior foraminal width (SFW), and middle foraminal width (MFW). Additional radiological evaluation for patients who underwent microscopic or micro-endoscopic lumbar foraminotomy was almost equivalent. Conclusion Percutaneous endoscopic lumbar foraminotomy is a minimally invasive technique that is as effective as conventional techniques for the treatment of foraminal stenosis.

Keywords

• percutaneous endoscopy
• foraminotomy
• foraminal stenosis