Endoscopic foraminoplasty: A prospective study on 250 consecutive patientswith independent evaluation

Objective: This study focused on the efficacy of endoscopic decompression o f the foramen guided by endoscopic aware-state pain source definition, Back ground Data: Endoscopic foraminoplasty consists of undercutting of the face t joint and endoscopic discectomy, mobilization and neurolysis of the exiti ng and transiting nerves, and ablation of osteophytes. This study sought th e outcome of endoscopic foraminoplasty in 250 consecutive patients followed for a minimum of 2 years, reviewed and assessed bp an external independent assessor. It was applied to patients with back pain and sciatica in multil evel degenerative disc disease and also to those with prior surgery. Method s: A prospective study of endoscopic laser foraminoplasty was performed on 121 males and 129 females with an average age of 48 years (21-86 years), fo llowed for an average period of 30 months (26-43 months), The average preop erative duration of hack, buttock, or leg pain was 6.1 years (5-11 years). A total of 30% had undergone prior open spinal surgery, Results: The cohort integrity at follow up was 97%. Outcome was analyzed using the percentage change in Oswestry Disability Scores and visual analogue pain scores. Clini cally relevant change in pain and disability nas observed in 73%. Using a p ercentage change in Oswestry Disability Score of 50 or more to determine go od and excellent outcomes, 60% of patients exceeded this score. A total of 95% patients required no further surgical intervention. Conclusions: Endosc opic laser foraminoplasty provides a minimalist means of exploring the extr aforaminal zone, the foramen, the disc, and the epidural space and performi ng discectomy, lateral recess decompression, osteophytectomy, and neural mo bilization.