Technical considerations in transforaminal endoscopic spine surgery at the thoracolumbar junction: report of 3 cases.

OBJECTIVE In this study the authors describe the technical considerations and feasibility of transforaminal discectomy and foraminoplasty for the treatment of lumbar radiculopathy in patients who have herniated discs at the thoracolumbar junction. METHODS After institutional review board approval, charts from 3 consecutive patients with lumbar radiculopathy and T12-L1 herniated discs who underwent endoscopic procedures between 2006 and 2014 were reviewed. RESULTS Consecutive cases (n = 1316) were reviewed to determine the incidence and success of surgery performed at the T12-L1 level.

Transforaminal endoscopic treatment of lumbar radiculopathy after instrumented lumbar spine fusion.

Background: Transforaminal endoscopic discectomy and foraminotomy is a well-described minimally invasive technique for surgically treating lumbar radiculopathy caused by a herniated disc and foraminal narrowing.

Objective: To describe the technique and feasibility of transforaminal foraminoplasty for the treatment of lumbar radiculopathy in patients who have already undergone instrumented spinal fusion.

Study Design: Retrospective study.

Transforaminal endoscopic discectomy with foraminoplasty for the treatment of spondylolisthesis.

Background: Lumbar degenerative spondylolisthesis is a common entity and occurs mainly in elderly patients. The trend in surgery has been to offer decompression with instrumented fusion based on patient-based outcome data and the inherent instability of the condition.

Objectives: Transforaminal endoscopic discectomy and foraminotomy is an ultra-minimally invasive outpatient surgical option available to patients that does not require general anesthesia and does not involve the same amount of destabilizing facet joint removal as a traditional laminectomy and medial facetectomy.

Outpatient, awake, ultra-minimally invasive endoscopic treatment of lumbar disc herniations.

Background: Endoscopic discectomy is an ultra- minimally invasive outpatient surgical option for the treatment of lumbar herniated discs. The purpose of this study was to assess the benefit of tranforaminal versus interlaminar endoscopic discectomy in patients with single level Lumbar 5-Sacral 1(L5-S1) disc herniations and lumbar radiculopathy.

Methods: After Institutional Review Board Approval, charts from 41 consecutive patients with complaints of lower back and radicular pain and an L5-S1 herniated disc who underwent an endoscopic procedure between 2007 and 2012 were reviewed.

Clinical success of transforaminal endoscopic discectomy with foraminotomy: a retrospective evaluation.

Objective: Transforaminal endoscopic surgery has evolved from an intradiscal procedure to a true foraminal epidural procedure where both a targeted discectomy and foraminal decompression can be performed. The success of transforaminal decompression for radiculopathy using preoperative selective nerve root block as part of a treatment algorithm for single level and multilevel lumbar disc herniations is described here.

Methods: After Institutional Review Board Approval, charts from 195 patients with complaints of lower back and radicular pain who received one or more endoscopic discectomy procedures were reviewed.

A retrospective evaluation of the clinical success of transforaminal endoscopic discectomy with foraminotomy in geriatric patients.

Background: The elderly population is growing in the United States. As the oldest old are projected to be the fastest growing part of the elderly population, we must consider how to best treat their degenerative spine conditions when non-operative treatment fails.

Objectives: Transforaminal endoscopic discectomy and foraminotomy is an ultra-minimally invasive outpatient surgical option that does not require general anesthesia and is available to geriatric.

Endoscopic transforaminal discectomy for an extruded lumbar disc herniation.

Microsurgery for lumbar herniated discs that require surgical intervention is a very successful and well-described technique, whether performed through more traditional "open" microsurgical retractors or through minimally-invasive "tube" retractors. Surgery for extruded lumbar disc fragments that migrate caudad or cephalad from the disc origin may typically require modifying the standard hemilaminotomy by removing additional laminar bone to retrieve the migrated fragment. Although midline and paramedian Wiltse approaches have been the standard methods for resecting herniated lumbar disc fragments, advances in neuroendoscopic techniques have expanded the potential targets for transforaminal endoscopic treatment to include extruded lumbar disc fragments.