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Awake transforaminal endoscopic lumbar facet cyst resection: technical note and case series
Matthew J Hagan1, Albert E Telfeian1, Rahul Sastry1
11Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Journal of Neurosurgery. Spine
|August 20, 2022
Summary
This study presents a minimally invasive transforaminal endoscopic decompression surgery for lumbar radiculopathy caused by facet cysts. The procedure showed significant pain reduction and improved function with no complications in awake patients.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Lumbar radiculopathy and compressive facet cysts significantly impact patient quality of life.
- Traditional surgical approaches may involve longer recovery times and potential complications.
Purpose of the Study:
- To describe a minimally invasive transforaminal surgical technique for treating awake patients with lumbar radiculopathy and compressive facet cysts.
- To evaluate the efficacy and safety of this awake endoscopic decompression procedure.
Main Methods:
- A retrospective review of 25 patients undergoing transforaminal endoscopic decompression for lumbar facet cysts between 2014 and 2020.
- The procedure was performed in awake patients utilizing a high-speed endoscopic drill.
- Nine patients had prior laminectomies at the treated level.
Main Results:
- Significant improvement in visual analog scale leg scores (7.6 to 2.3) and Oswestry Disability Index (39.7% to 13.0%) at 2-year follow-up.
- No complications, readmissions, or symptom recurrence were reported during the follow-up period.
- The technique was effective even in patients with post-laminectomy facet cysts.
Conclusions:
- Minimally invasive awake transforaminal endoscopic decompression is a safe and effective treatment for lumbar facet cysts causing radiculopathy.
- This technique offers a viable option, particularly for patients with prior laminectomies.
