Full-Endoscopic Midline Foraminoplasty: An Alternative Method for Treating Lumbar Foraminal Stenosis

To describe the full-endoscopic lumbar foraminoplasty with midline skin incision (FEFM) and lateral recess decompression procedure and to report its clinical outcomes at the 1-year follow-up.

Consecutive patients with lumbar foraminal and/or lateral recess stenosis who underwent FEFM procedures were retrospectively reviewed. Clinical outcomes were evaluated with a visual analogue scale (VAS) of back and leg pain and Oswestry Disability Index (ODI) up to 1 year postoperatively. The complications and recurrence rate were also recorded.

A total of 30 cases (51 levels) were included (L3-4, 6 cases [11.8%]; L4-5, 23 [45.1%]; L5-S1, 22 cases [43.1%]). VAS scores collected at preoperative, postoperative day 1, 3 months, 6 months, and 1 year were 9.16, 1.7, 1.36, 1.3, and 1.43, respectively. The ODI scores collected at preoperative, postoperative 3 months, 6 months, and 1 year were 46.63, 11.5, 10.66, and 10.46, respectively (p<0.05). The mean operation time was 88.7 minutes (range, 45-152 minutes). The length of hospital stay was 1.21 days (range, 1-3 days). No immediate complications were identified, and no patients experienced a recurrence of symptoms requiring revision surgery.

FEFM is an effective procedure for treating foraminal and/or lateral recess stenosis. It demonstrates the capability to decompress both bilateral foraminal and lateral recess stenosis through a single-entry point.