Endoscopic Transforaminal and Lateral Recess Decompression After Previous Spinal Surgery.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Procedures

Background:

• Persistent leg and back pain after lumbar laminectomy or fusion is often due to spinal stenosis.
• Recurrent symptoms may arise from incomplete decompression or cage subsidence, impacting spinal and neuroforaminal height.

Purpose of the Study:

• To evaluate the feasibility of outpatient transforaminal decompression as a revision surgery alternative.
• To minimize surgical complications, reduce costs, and expedite patient recovery and return to daily activities.

Main Methods:

• 48 patients with prior lumbar surgery underwent endoscopic transforaminal decompression for persistent stenosis.
• Outcomes were assessed over 2 years using VAS, ODI, and modified Macnab criteria.

Main Results:

• Significant ODI reduction (44.6%) in patients with single/two-level prior surgery; 79.1% achieved excellent/good results (modified Macnab).
• Mean VAS score decreased from 7.7 to 2.3 (P < .01).
• Outpatient endoscopic surgery led to faster return to work (2.6 weeks vs. 8.1 weeks) and reduced direct (40.6%) and indirect (37.1%) costs.

Conclusions:

• Transforaminal decompression is an effective and safe outpatient alternative for revision lumbar surgery.
• It successfully treats symptomatic spinal stenosis, offering cost savings and improved patient recovery.