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Related Experiment Video

Updated: Apr 17, 2026

Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis

Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis

Published on: October 17, 2025

Endoscopic foraminal decompression for failed back surgery syndrome under local anesthesia.

Anthony Yeung¹, Satishchandra Gore²

¹Desert Institute for Spine Care, Phoenix, AZ, USA.

International Journal of Spine Surgery

|February 20, 2015

Summary

Minimally invasive endoscopic surgery effectively treats failed back surgery syndrome (FBSS) by addressing unrecognized spinal stenosis and disc herniation. This approach offers significant pain relief and avoids more invasive fusion procedures.

Keywords:

Failed Back Surgery Syndrome(FBSS)Foraminal decompression Foraminal osteophyte Hidden zone Lateral stenosis Recurrent herniation

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Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis

Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis

Published on: February 24, 2023

Area of Science:

Neurosurgery
Orthopedic Surgery
Minimally Invasive Spine Surgery

Background:

Failed back surgery syndrome (FBSS) commonly results from residual/recurrent herniation, fibrosis, or stenosis.
Traditional open revision surgery can increase instability and necessitate fusion.
Endoscopic minimally invasive surgery (MIS) offers an alternative for treating unrecognized causative patho-anatomy in FBSS.

Purpose of the Study:

To evaluate the effectiveness of percutaneous transforaminal endoscopic discectomy and foraminoplasty in treating FBSS.
To address unrecognized lateral stenosis and/or residual/recurrent disc herniation.
To offer patients an alternative to repeat open surgery or fusion.

Main Methods:

Thirty consecutive patients with FBSS underwent percutaneous transforaminal endoscopic discectomy and foraminoplasty.
Patients had prior unsuccessful open translaminar surgery for disc herniation or spinal stenosis.
Endoscopic foraminoplasty decompressed the bony foramen and allowed visualization of nerve roots in the "hidden zone" of Macnab.

Main Results:

Average pre-operative VAS improved from 7.2 to 4.0; ODI improved from 48% to 31%.
Temporary dysesthesia occurred in 4 patients, but all reported additional relief and avoided open decompression or fusion.
Patients experienced significant relief from pre-operative symptoms.

Conclusions:

The transforaminal endoscopic approach is effective for FBSS caused by residual/recurrent herniation and lateral stenosis.
This MIS technique effectively decompresses the foramen without destabilizing the spine.
It provides a valuable option for FBSS treatment, avoiding more invasive procedures.