Transforaminal Full-Endoscopic Surgery for Lumbar Foraminal Pathologies: A Comparative Clinical Effectiveness Study.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Procedures

Background:

• Full-endoscopic surgery is gaining traction for lumbar foraminal pathologies.
• Specific indications for this minimally invasive approach require clarification.

Purpose of the Study:

• To assess patient-reported outcomes following transforaminal full-endoscopic spine surgery for diverse lumbar foraminal conditions.
• To determine the effectiveness of endoscopic decompression for various foraminal pathologies.

Main Methods:

• Multicenter prospective cohort study involving 83 patients undergoing full-endoscopic decompression.
• Patient-reported outcomes (low back pain, leg pain, Oswestry Disability Index) were tracked via a mobile app for 6 months.
• Six-month outcome measures served as the primary endpoint to evaluate treatment efficacy.

Main Results:

• Both endoscopic discectomies and foraminotomies significantly improved pain and Oswestry Disability Index scores.
• Improvement was not dependent on the severity of foraminal stenosis shown on MRI.
• Vertical foraminal stenosis demonstrated the lowest treatment response rate.

Conclusions:

• Transforaminal full-endoscopic surgery offers clinically meaningful relief for most lumbar foraminal pathologies.
• The efficacy of endoscopic decompression for vertical foraminal stenosis is limited and needs additional study.