scholarly journals Partial Facetectomy for Lumbar Foraminal Stenosis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kevin Kang ◽  
Juan Carlos Rodriguez-Olaverri ◽  
Frank Schwab ◽  
Jenifer Hashem ◽  
Afshin Razi ◽  
...  
Keyword(s):  
Nerve Root ◽  
Functional Limitations ◽  
Effective Means ◽  
Neurogenic Claudication ◽  
Spinal Instability ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Additional Surgery ◽  
Lumbar Nerve Root ◽  
Failed Back Surgery

Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms.Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes.Results. 27 of 47 patients (57%) reported no back pain and no functional limitations. Eight of 47 patients (17%) reported moderate pain, but had no limitations. Six of 47 patients (13%) continued to experience degenerative symptoms. Five of 47 patients (11%) required additional surgery.Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.

scholarly journals Imaging diagnosis of lumbar foraminal stenosis in the fifth lumbar nerve root: reliability and reproducibility of T1-weighted three-dimensional lumbar MRI

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Ko Hashimoto ◽  
Yasuhisa Tanaka ◽  
Takumi Tsubakino ◽  
Takeshi Hoshikawa ◽  
Tomowaki Nakagawa ◽  
...  
Keyword(s):  
Nerve Root ◽  
Three Dimensional ◽  
Foraminal Stenosis ◽  
Imaging Diagnosis ◽  
Lumbar Foraminal Stenosis ◽  
Lumbar Nerve Root ◽  
Lumbar Mri

Comparison of Pain-reducing Effect After Selective Nerve Root Block According to the Type of Lumbar Foraminal Stenosis

2019 ◽  
Vol 32 (2) ◽  
pp. E60-E64 ◽  
Author(s):  
Sangbong Ko ◽  
Jaibum Kwon ◽  
Youngsik Lee ◽  
Seungbum Chae ◽  
Wonkee Choi
Keyword(s):  
Nerve Root ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Nerve Root Block ◽  
Selective Nerve Root Block

scholarly journals A less invasive surgery using a full-endoscopic system for L5 nerve root compression caused by lumbar foraminal stenosis

2018 ◽  
Vol 4 (3) ◽  
pp. 594-601
Author(s):  
Katsuhiko Ishibashi ◽  
Yasushi Oshima ◽  
Hirokazu Inoue ◽  
Yuichi Takano ◽  
Hiroki Iwai ◽  
...  
Keyword(s):  
Invasive Surgery ◽  
Nerve Root ◽  
Foraminal Stenosis ◽  
Nerve Root Compression ◽  
Less Invasive Surgery ◽  
Lumbar Foraminal Stenosis ◽  
Less Invasive

Nerve root anomalies: implications for transforaminal lumbar interbody fusion surgery and a review of the Neidre and Macnab classification system

2013 ◽  
Vol 35 (2) ◽  
pp. E9 ◽  
Author(s):  
Shane M. Burke ◽  
Mina G. Safain ◽  
James Kryzanski ◽  
Ron I. Riesenburger
Keyword(s):  
Nerve Root ◽  
Classification System ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Radicular Pain ◽  
Neurogenic Claudication ◽  
Lumbar Interbody Fusion ◽  
Lumbar Nerve Root ◽  
History Of ◽  
Mini Open

Lumbar nerve root anomalies are uncommon phenomena that must be recognized to avoid neural injury during surgery. The authors describe 2 cases of nerve root anomalies encountered during mini-open transforaminal lumbar interbody fusion (TLIF) surgery. One anomaly was a confluent variant not previously classified; the authors suggest that this variant be reflected in an amendment to the Neidre and Macnab classification system. They also propose strategies for identifying these anomalies and avoiding injury to anomalous nerve roots during TLIF surgery. Case 1 involved a 68-year-old woman with a 2-year history of neurogenic claudication. An MR image demonstrated L4–5 stenosis and spondylolisthesis and an L-4 nerve root that appeared unusually low in the neural foramen. During a mini-open TLIF procedure, a nerve root anomaly was seen. Six months after surgery this patient was free of neurogenic claudication. Case 2 involved a 60-year-old woman with a 1-year history of left L-4 radicular pain. Both MR and CT images demonstrated severe left L-4 foraminal stenosis and focal scoliosis. Before surgery, a nerve root anomaly was not detected, but during a unilateral mini-open TLIF procedure, a confluent nerve root was identified. Two years after surgery, this patient was free of radicular pain.

scholarly journals Microendoscopic Surgical Treatment for Lumbar Foraminal Stenosis with an Anomalous Lumbosacral Nerve Root: A Case Report

2012 ◽  
Vol 61 (3) ◽  
pp. 543-546
Author(s):  
Toshifumi Tamura ◽  
Toru Fujimoto ◽  
Akira Sei ◽  
Takuya Taniwaki ◽  
Tatsuya Okada ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Nerve Root ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis

scholarly journals Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elisabeth Sartoretti ◽  
Michael Wyss ◽  
Alex Alfieri ◽  
Christoph A. Binkert ◽  
Cyril Erne ◽  
...  
Keyword(s):  
High Resolution ◽  
Morphological Change ◽  
Nerve Root ◽  
Grading System ◽  
Foraminal Stenosis ◽  
Mr Images ◽  
Anatomical Structures ◽  
Lumbar Foraminal Stenosis ◽  
High Resolution Mri ◽  
Anterior Position

AbstractIn this paper we sought to develop and assess the reproducibility of an updated 6-point grading system for lumbar foraminal stenosis based on the widely used Lee classification that more accurately describes lumbar foraminal stenosis as seen on high-resolution MRI. Grade A indicates absence of foraminal stenosis. Grades B, C, D and E indicate presence of foraminal stenosis with contact of the nerve root with surrounding anatomical structures (on one, two, three or four sides for B, C, D and E respectively) yet without morphological change of the nerve root. To each grade, a number code indicating the location of contact between the nerve root and surrounding anatomical structure(s) is appended. 1, 2, 3 and 4 indicate contact of the nerve root at superior, posterior, inferior and anterior position of the borders of the lumbar foramen. Grade F indicates presence of foraminal stenosis with morphological change of the nerve root. Three readers graded the lumbar foramina of 101 consecutive patients using high-resolution T2w (and T1w) MR images with a spatial resolution of beyond 0.5 mm3. Interreader agreement was excellent (Cohen’s Kappa = 0.866–1). Importantly, 30.6%/31.6%/32.2% (reader 1/reader 2/ reader 3) of foramina were assigned grades that did not appear in the original Lee grading system (grades B and D). The readers found no foramen that could not be described accurately with the updated grading system. Thus, an updated 6-point grading system for lumbar foraminal stenosis is reproducible and comprehensively describes lumbar foraminal stenosis as seen on high-resolution MRI.

scholarly journals Factors Associated with Successful Response to Balloon Decompressive Adhesiolysis Neuroplasty in Patients with Chronic Lumbar Foraminal Stenosis

2019 ◽  
Vol 8 (11) ◽  
pp. 1766 ◽  
Author(s):  
Oh ◽  
Kim ◽  
Park ◽  
Ji ◽  
Shin ◽  
...  
Keyword(s):  
Steroid Injection ◽  
Balloon Catheter ◽  
Multivariate Logistic Regression Analysis ◽  
Neurogenic Claudication ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Factors Associated ◽  
Refractory Pain ◽  
Epidural Steroid

Epidural neuroplasty, often called percutaneous epidural adhesiolysis, is often performed in refractory patients with chronic lumbar radiculopathy or neurogenic claudication. Recent studies have showed that decompressive adhesiolysis with an inflatable balloon catheter (balloon neuroplasty) is efficient in patients who experience refractory pain from epidural steroid injection or even epidural neuroplasty with a balloon-less catheter. However, exact indications or predictive factors for epidural balloon neuroplasty have not been fully evaluated. Therefore, to assess associated factors that could affect a favorable outcome, we analyzed a prospectively collected multicenter cohort of patients with chronic refractory lumbar foraminal stenosis after balloon neuroplasty. At the 6-month point in follow-up, 92 (44.4%) patients among 207 subjects were classified as successful responders according to a robust combination of outcome measures. Multivariate logistic regression analysis also showed that mild grade lumbar foraminal stenosis may be an independent factor associated with a successful response 6 months after balloon neuroplasty (odds ratio = 2.829; 95% confidence interval = 1.351–5.923; p = 0.006). However, we found that there were 29.4% and 24.6% successful responders with moderate and severe foraminal stenosis, respectively. Attempting balloon neuroplasty in refractory lumbar foraminal stenosis, especially mild grade, may be worthwhile. 

Percutaneous Endoscopic Lumbar Foraminoplasty for Lumbar Foraminal Stenosis of Elderly Patients with Unilateral Radiculopathy: Radiographic Changes in Magnetic Resonance Images

2019 ◽  
Vol 80 (04) ◽  
pp. 302-311 ◽  
Author(s):  
Jongchul Chung ◽  
Changbong Kong ◽  
Woosung Sun ◽  
Dohyung Kim ◽  
Hyungdong Kim ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Elderly Patients ◽  
Nerve Root ◽  
Magnetic Resonance Images ◽  
Foraminal Stenosis ◽  
Cross Sectional ◽  
Lumbar Foraminal Stenosis ◽  
Before And After ◽  
Foraminal Height ◽  
Radiographic Changes

Background and Study Aims/Objective Clinical outcomes of percutaneous endoscopic lumbar foraminoplasty (PELF) performed for lumbar foraminal stenosis (LFS) have been reported in the literature. However, no study has reported the radiographic changes in magnetic resonance imaging (MRI) after surgery. This report presents the clinical outcome as well as radiographic changes in MRI after PELF for elderly patients with unilateral radiculopathy. We also describe detailed operative nuances to expand the foraminal space and mobilize the affected nerve root. Material and Methods Between January 2015 and December 2016, 24 patients over 65 years of age underwent PELF to treat unilateral radiculopathy caused by LFS. The demographics, medical history, visual analog scale (VAS), and Oswestry Disability Index (ODI) were reviewed retrospectively. MRI radiographic data, cross-sectional area (CSA) of the affected foramen and nerve root, were evaluated before and after surgery. Results Preoperative radiculopathy improved in 23 of 24 patients (96%). The VAS score significantly improved from 7.89 ± 1.8 to 2.57 ± 2.5 (67.4%). The ODI also significantly improved from 33.15 ± 9.2 to 10.24 ± 6.7 (69.1%). Foraminal width increased ∼ 1.67 mm (21.4%), foraminal height increased 5.00 mm (36.9%), and CSA increased about 55.27 mm2 (60.6%) (p < 0.001). The CSA and the shape of the affected nerve section also expanded, but these were not statistically significant. Conclusion We performed PELF in elderly patients with LFS. There were considerable radiographic changes in MRI, and the patients also showed clinically relevant improvement. Thus PELF resulted in sufficient decompression of the nerve root in LFS.

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