• Kosuke Sugiura, Cathryn Payne, Nguyen T Tran, Jannik Leyendecker, John Ogunlade, Mary LaVanne, Peter B Derman, Robert Quon, Albert E Telfeian, Christoph P Hofstetter, and Endoscopic Spine Research Group (ESRG).
• Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
• Neurosurgery. 2025 Mar 1; 96 (3S): S51S62S51-S62.

Background And ObjectivesFull-endoscopic surgery is increasingly used for treating lumbar foraminal pathologies, though the specific indications remain unclear. This study aims to evaluate patient-reported outcomes after transforaminal full-endoscopic spine surgery for various lumbar foraminal conditions.MethodsMulticenter cohort study of patients with intervertebral lumbar foraminal pathology who underwent full-endoscopic decompression at four medical centers. Postoperative patient-reported outcomes, including low back and leg pain as well as Oswestry Disability Index (ODI) scores, were prospectively tracked using a mobile app for 6 months. Six-month outcome measures (patient-reported outcome measures) were used as the primary outcome variable to determine treatment effectiveness regarding various foraminal pathologies.ResultsA total of 83 patients with a mean age of 57.04 ± 1.63 years were included. The most common operative levels were L4/5 for transforaminal endoscopic discectomies (59.6%) and L5/S1 for endoscopic foraminotomies (58.1%). Endoscopic discectomies resulted in significant improvements in Visual Analog Scale scores for low back pain (from 5.85 ± 0.43 to 3.02 ± 0.41; P < .001), leg pain (from 6.66 ± 0.34 to 3.12 ± 0.57; P < .001), and ODI scores (from 24.39 ± 1.35 to 12.32 ± 176; P < .001). Endoscopic foraminotomies also resulted in significant improvements in Visual Analog Scale scores for low back pain (from 5.58 ± 0.53 to 3.68 ± 0.58; P < .001) and leg pain (from 6.42 ± 0.47 to 4.21 ± 0.58; P < .001), as well as ODI scores (from 19.28 ± 1.41 to 14.67 ± 2.03; P < .01). The amount of improvement was independent of the severity of foraminal stenosis, as determined on preoperative MRI. However, vertical foraminal stenosis was associated with the lowest treatment response rate.ConclusionEndoscopic foraminotomies result in clinically meaningful symptomatic improvement for most lumbar foraminal pathologies. However, the effectiveness of decompression surgery for vertical foraminal stenosis is limited and requires further investigation.Copyright © Congress of Neurological Surgeons 2025. All rights reserved.

21 keywords...

hide…