ArticleInternational journal of spine surgery2025
Impact of Extended Endoscopic Lumbar Foraminotomy on Postoperative Surgical Outcomes: Is Greater Decompression Beneficial?
Article in International journal of spine surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Procedure-Specific Postoperative Drainage Strategy in Transforaminal Full-Endoscopic Spine Surgery: A Quantitative Evaluation of Drain Output and Endoscopic Bleeding Findings.International journal of spine surgery · 2026Article
- Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for Adjacent Segment Foraminal Stenosis After Lumbar Fusion: Clinical and Radiological Outcomes.International journal of spine surgery · 2026Article
- Latent Risk of Visceral Injury in Upper Lumbar Endoscopic Surgery: A Prone-Position Computed Tomography Analysis Identifying Low Body Mass Index as a Predictor of Narrow Safety Margins.International journal of spine surgery · 2026Article
- Transforaminal Endoscopic Lumbar Foraminotomy for Radiculopathy at the Fused Segment After Lumbar Fusion: Clinical Outcomes and Surgical Considerations.Journal of clinical medicine · 2026Article
- Pathological Patterns and Technical Considerations in Transforaminal Endoscopic Lumbar Foraminotomy for Fusion-Segment Radicular Pain.Journal of pain research · 2026Article
- Staged Full-endoscopic Foraminotomy for Multilevel Lumbar Stenosis with Scoliosis: A Case Report.NMC case report journal · 2026Article
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11 authors.
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Abstract
backgroundThe transforaminal (TF) approach in full endoscopic spine surgery (FESS) is the least invasive spinal surgery, as it can be performed under local anesthesia with only an 8-mm skin incision. Transforaminal FESS-based foraminotomy was first performed in the early 2000s for the decompression of foraminal stenosis. The technique has improved year by year over the past 2 decades. In our hospital, full endoscopic lumbar foraminotomy (FELF) has been performed since 2015. Since our development of the FESS undercutting laminectomy procedures in 2019, the size of the decompressed area achieved by FELF has increased.
objectiveTo estimate the technical alteration of FELF over time by comparing the pre- and postoperative osseous foraminal areas (FAs) between traditional and advanced FELF techniques.
methodsFifty-two cases were retrospectively reviewed. In the early phase of FELF before 2019, partial or total resection of the superior articular process (SAP) was performed. Twenty-six of the patients were treated using the traditional FELF procedure (SAP-ectomy group). The remaining 26 underwent advanced FELF procedures, including SAP-ectomy, undercutting laminectomy, and removal of the ligamentum flavum (advanced FELF group). Clinical outcomes were assessed using the modified MacNab score. Pre- and postoperative osseous FAs were measured on sagittal computed tomography, and data were compared between the SAP-ectomy and advanced FELF groups. Paired and unpaired
resultsBy the modified MacNab score, the excellent/good rate was 82.6% in the SAP-ectomy group and 95.5% in the advanced FELF group. The improvement was greater in advanced FELF but not significantly. FA prior to surgery was 87.5 ± 27.0 mm
conclusionFull endoscopic foraminotomy techniques have evolved over time. The recently developed advanced FELF technique appears to safely and effectively achieve better clinical outcomes by significantly enlarging FA. CLINICAL RELEVANCE: The advanced FELF technique contributes to improved decompression of the exiting nerve root. LEVEL OF EVIDENCE: 3:
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