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Updated: Jul 7, 2026
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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
Published on: October 17, 2025
[Paraspinal approach to lumbar foraminal tumor]
Kyongsong Kim1, Toyohiko Isu, Atsushi Sugawara
1Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Japan.
No Shinkei Geka. Neurological Surgery
|February 13, 2008
Summary
A less invasive paraspinal approach effectively removed Eden type IV lumbar tumors without total facetectomy. This method, utilizing phased foraminal expansion and intratumoral decompression, avoids fusion and instability, offering a viable treatment option.
Area of Science:
- Neurosurgery
- Spinal Oncology
Context:
- Lumbar foraminal tumors require tailored surgical approaches based on size and location.
- Traditional methods like total facetectomy and combined intra-/extraspinal approaches offer wide access but necessitate facet fusion and are invasive.
Purpose:
- To evaluate the efficacy of a less invasive paraspinal approach for treating Eden type IV lumbar tumors.
- To demonstrate the feasibility of removing these tumors without complete facetectomy or intraspinal extension.
Summary:
- Four patients with Eden type IV lumbar tumors (3 neurofibromas, 1 schwannoma) underwent surgical removal exclusively via a paraspinal approach.
- Phased foraminal expansion using a SONOPET device and intratumoral decompression with CUSA and PAL-I were crucial for tumor removal.
- No total facetectomy, fusion, or intraspinal approach was needed, and no recurrence or instability was observed post-operatively.
Impact:
- This less invasive paraspinal technique provides an effective and safe alternative for managing Eden type IV lumbar tumors.
- Successful application of SONOPET and CUSA/PAL-I facilitates tumor resection while preserving spinal stability.
- Reduces surgical invasiveness and potential complications associated with traditional facetectomy and fusion procedures.
