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Published in: Acta Neurochirurgica 3/2022

01-03-2022 | Endoscopy | How I Do it - Spine degenerative

Percutaneous endoscopic lumbar foraminotomy: how I do it

Authors: Yong Ahn, Sang Gu Lee

Published in: Acta Neurochirurgica | Issue 3/2022

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Abstract

Background

Percutaneous endoscopic lumbar foraminotomy (PELF) is a good alternative for foraminal stenosis. The steep learning curve and lack of a practical manual can make this technique challenging.

Method

We describe a step-by-step technique based on the literature review and our experience in actual practice: (1) posterolateral foraminal landing, (2) bony unroofing of the superior articular process, and (3) full-scale soft tissue decompression. Technical tips for preventing complications are also discussed.

Conclusion

PELF may be effective and minimally invasive. Standardized surgical techniques are essential for clinical success.
Appendix
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Literature
1.
go back to reference Ahn Y, Kim JU, Lee BH, Lee SH, Park JD, Hong DH, Lee JH (2009) Postoperative retroperitoneal hematoma following transforaminal percutaneous endoscopic lumbar discectomy. J Neurosurg Spine 10:595–602CrossRef Ahn Y, Kim JU, Lee BH, Lee SH, Park JD, Hong DH, Lee JH (2009) Postoperative retroperitoneal hematoma following transforaminal percutaneous endoscopic lumbar discectomy. J Neurosurg Spine 10:595–602CrossRef
2.
go back to reference Ahn Y, Lee SH, Park WM, Lee HY (2003) Posterolateral percutaneous endoscopic lumbar foraminotomy for L5–S1 foraminal or lateral exit zone stenosis. Technical note. J Neurosurg 99:320–323CrossRef Ahn Y, Lee SH, Park WM, Lee HY (2003) Posterolateral percutaneous endoscopic lumbar foraminotomy for L5–S1 foraminal or lateral exit zone stenosis. Technical note. J Neurosurg 99:320–323CrossRef
3.
go back to reference Ahn Y, Oh HK, Kim H, Lee SH, Lee HN (2014) Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery 75:124–133CrossRef Ahn Y, Oh HK, Kim H, Lee SH, Lee HN (2014) Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery 75:124–133CrossRef
4.
go back to reference Choi I, Ahn JO, So WS, Lee SJ, Choi IJ, Kim H (2013) Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety. Eur Spine J 22:2481–2487CrossRef Choi I, Ahn JO, So WS, Lee SJ, Choi IJ, Kim H (2013) Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety. Eur Spine J 22:2481–2487CrossRef
5.
go back to reference Jasper GP, Francisco GM, Telfeian AE (2013) A retrospective evaluation of the clinical success of transforaminal endoscopic discectomy with foraminotomy in geriatric patients. Pain Physician 16:225–229PubMed Jasper GP, Francisco GM, Telfeian AE (2013) A retrospective evaluation of the clinical success of transforaminal endoscopic discectomy with foraminotomy in geriatric patients. Pain Physician 16:225–229PubMed
6.
go back to reference Kambin P, O’Brien E, Zhou L, Schaffer JL (1998) Arthroscopic microdiscectomy and selective fragmentectomy. Clin Orthop Relat Res 347:150–167CrossRef Kambin P, O’Brien E, Zhou L, Schaffer JL (1998) Arthroscopic microdiscectomy and selective fragmentectomy. Clin Orthop Relat Res 347:150–167CrossRef
7.
go back to reference Knight MT, Vajda A, Jakab GV, Awan S (1998) Endoscopic laser foraminoplasty on the lumbar spine–early experience. Minim Invasive Neurosurg 41:5–9CrossRef Knight MT, Vajda A, Jakab GV, Awan S (1998) Endoscopic laser foraminoplasty on the lumbar spine–early experience. Minim Invasive Neurosurg 41:5–9CrossRef
8.
go back to reference Müller SJ, Burkhardt BW, Oertel JM (2018) Management of dural tears in endoscopic lumbar spinal surgery: a review of the literature. World Neurosurg 119:494–499CrossRef Müller SJ, Burkhardt BW, Oertel JM (2018) Management of dural tears in endoscopic lumbar spinal surgery: a review of the literature. World Neurosurg 119:494–499CrossRef
9.
go back to reference Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 33:931–939 Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 33:931–939
10.
go back to reference Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 27:722–731 Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 27:722–731
Metadata
Title
Percutaneous endoscopic lumbar foraminotomy: how I do it
Authors
Yong Ahn
Sang Gu Lee
Publication date
01-03-2022
Publisher
Springer Vienna
Keyword
Endoscopy
Published in
Acta Neurochirurgica / Issue 3/2022
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-022-05114-z

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