Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal...

Area of Science:

• Spinal Surgery
• Minimally Invasive Procedures
• Neurosurgery

Background:

• Adjacent segment disease (ASD) at L5/S1 poses surgical challenges.
• Conventional fusion extension surgery for ASD sacrifices spinal mobility and increases morbidity.
• Revision surgery for foraminal stenosis in ASD requires specialized techniques.

Purpose of the Study:

• To describe a motion-preserving surgical alternative for L5/S1 adjacent segment disease (ASD).
• To detail a step-by-step protocol for transforaminal full-endoscopic foraminotomy under local anesthesia.
• To present a technique for revision cases avoiding fusion extension.

Main Methods:

• Transforaminal full-endoscopic foraminotomy under local anesthesia.
• Utilized a posterolateral corridor, avoiding prior surgical scarring.
• Key steps included preoperative planning, foraminoplasty, SAP resection, LF release, and removal.

Main Results:

• Successful osseous decompression confirmed by postoperative CT scans.
• Immediate improvement in radicular pain and motor weakness.
• Visual analog scale score improved from 9/10 to 1/10 at one-month follow-up.

Conclusions:

• Transforaminal full-endoscopic foraminotomy is an effective motion-preserving option for L5/S1 ASD.
• The technique provides significant neural decompression and rapid recovery.
• Offers a valuable alternative to extensive fusion surgery in challenging cases.