• Youn-Kwan Park, Joo Han Kim, Hung Seob Chung, and Jung Keun Suh.
• Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea. ykapa@kumc.or.kr
• J. Neurosurg. 2003 Apr 1; 98 (3 Suppl): 264-70.

ObjectWhen performing surgery, the extraforaminal window is very narrow at the L5-S1 level. The authors describe a microsurgical method for decompression of the L-5 nerve root trapped between a marginal osteophyte of the vertebral body and the transverse process. The procedure was performed in 16 patients with extraforaminal stenosis.MethodsThe cranial part of the L5-S1 facet joint and the caudal portion of the pedicle and transverse process of L-5 were removed via a midline skin incision and partial resection of the pars interarticularis; a high-speed drill was used as was a surgical microscope. The affected nerve root was decompressed and mobilized cranially. Postoperatively all patients reported excellent relief of their sciatic pain, and there were no technique-associated complications. There was no recurrence during the follow-up period, that ranged from 14 to 70 months.ConclusionsThe authors recommend this technique for the effective decompression of symptomatic extraforaminal L5-S1 stenosis. The need for a dangerous and tedious removal of the vertebral osteophyte together with spinal fusion is avoided.

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