Eccentric technique for foraminoplasty in percutaneous endoscopic transforaminal procedure: A technical note

Area of Science:

• Minimally Invasive Spine Surgery
• Neurosurgery
• Orthopedic Surgery

Background:

• Percutaneous endoscopic transforaminal procedures are utilized for spinal decompression.
• Foraminoplasty is a key step in these procedures, often requiring multiple trepan sizes.
• A modified technique aims to optimize the foraminoplasty step.

Purpose of the Study:

• To describe a novel modified technique for foraminoplasty.
• To evaluate the efficacy and safety of this eccentric technique.
• To compare outcomes with traditional methods.

Main Methods:

• A modified eccentric foraminoplasty technique was used in 58 patients.
• A single, flexible-angled trepan was guided by a kirschner wire under fluoroscopy.
• The technique aimed to avoid step-by-step dilation and slippage.

Main Results:

• Mean operation time was 65 minutes; mean blood loss was 12 ml.
• Reduced fluoroscopy duration (mean 20.4s) and radiation dose (mean 0.9 mSv).
• No complications, excellent foraminoplasty on CT, and early discharge (2nd day).

Conclusions:

• The modified eccentric technique simplifies foraminoplasty.
• It shortens operative time and reduces intraoperative fluoroscopy.
• The technique is effective and safe for percutaneous endoscopic transforaminal procedures.