scholarly journals Full‐Endoscopic Foraminotomy with a Novel Large Endoscopic Trephine for Severe Degenerative Lumbar Foraminal Stenosis at L 5 S 1 Level: An Advanced Surgical Technique

2021 ◽  
Author(s):  
Qing‐peng Song ◽  
Bao Hai ◽  
Wen‐kui Zhao ◽  
Xin Huang ◽  
Kai‐xi Liu ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis

Is multidetector computed tomography comparable to magnetic resonance imaging for assessment of lumbar foraminal stenosis?

2016 ◽  
Vol 58 (2) ◽  
pp. 197-203
Author(s):  
Woo Young Kang ◽  
Joong Mo Ahn ◽  
Joon Woo Lee ◽  
Eugene Lee ◽  
Yun Jung Bae ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Multidetector Computed Tomography ◽  
Excellent Agreement ◽  
Observer Agreement ◽  
Kappa Statistics ◽  
Foraminal Stenosis ◽  
Resonance Imaging ◽  
Lumbar Foraminal Stenosis

Background Both multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are used for assessment of lumbar foraminal stenosis (LFS). Therefore, it is relevant to assess agreement between these imaging modalities. Purpose To determine intermodality, inter-, and intra-observer agreement for assessment of LFS on MDCT and MRI. Material and Methods A total of 120 foramina in 20 patients who visited our institution in January and February 2014 were evaluated by six radiologists with different levels of experience. Radiologists evaluated presence and severity of LFS on sagittal CT and MR images according to a previously published LFS grading system. Intermodality agreement was analyzed by using weighted kappa statistics, while inter- and intra-observer agreement were analyzed by using intraclass correlation coefficients (ICCs) and kappa statistics. Results Overall intermodality agreement was moderate to good (kappa, 0.478–0.765). In particular, two professors and one fellow tended to overestimate the degree of LFS on CT compared with MRI. For inter-observer agreement of all six observers, ICCs indicated excellent agreement for both CT (0.774) and MRI (0.771), while Fleiss’ kappa values showed moderate agreement for CT (0.482) and MRI (0.575). There was better agreement between professors and fellows compared with residents. For intra-observer agreement, ICCs indicated excellent agreement, while kappa values showed good to excellent agreement for both CT and MRI. Conclusion MDCT was comparable to MRI for diagnosis and assessment of LFS, especially for experienced observers. However, there was a tendency to overestimate the degree of LFS on MDCT compared with MRI.

scholarly journals Author Correction: Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elisabeth Sartoretti ◽  
Michael Wyss ◽  
Alex Alfieri ◽  
Christoph A. Binkert ◽  
Cyril Erne ◽  
...  
Keyword(s):  
High Resolution ◽  
Mr Imaging ◽  
Grading System ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis

scholarly journals Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations

2020 ◽  
Vol 9 (4) ◽  
pp. 981
Author(s):  
Chan-Sik Kim ◽  
Yeon-Jin Moon ◽  
Jae Won Kim ◽  
Dong-Min Hyun ◽  
Shill Lee Son ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Treatment Options ◽  
Balloon Catheter ◽  
Radicular Pain ◽  
Treatment Modalities ◽  
Foraminal Stenosis ◽  
The Novel ◽  
Lumbar Foraminal Stenosis ◽  
Transforaminal Approach ◽  
Technical Considerations

Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5–S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5–S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p < 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here.

357 Comparative Effectiveness between Primary and Revision Foraminotomy for the Treatment of Lumbar Foraminal Stenosis

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 282-282
Author(s):  
Emily Hu ◽  
Jianning Shao ◽  
Heath P Gould ◽  
Roy Xiao ◽  
Colin Haines ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
Minimum Clinically Important Difference ◽  
Functional Score ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Clinically Important Difference ◽  
Significant Difference ◽  
Functional Scores

Abstract INTRODUCTION Foraminotomy has demonstrated clinical benefit for the management of lumbar foraminal stenosis (LFS). Although many patients undergo multiple foraminotomies, there is little data comparing primary foraminotomy (PF) and revision foraminotomy (RF) in terms of cost and quality of life (QOL) outcomes. METHODS A retrospective cohort study was conducted among patients undergoing foraminotomy for LFS. QOL instruments (EQ-5D, PDQ, and PHQ-9) were prospectively collected between 2008 and 2016. Outcome measures included improvement in postoperative QOL, perioperative cost, and QOL minimum clinically important difference (MCID). RESULTS >579 procedures were eligible 476 (82%) PF and 103 (18%) RF. A significantly higher proportion of males underwent RF than PF (71% vs. 59%, P = 0.03) and PF was done on a significantly higher number of vertebral levels (2.2 vs. 2.0, P = 0.04). There were no other significant differences in demographics. Preoperatively, mean PDQ-Functional scores (50 vs. 54, P = 0.04), demonstrated significantly poorer QOL in the RF cohort. Postoperatively, EQ-5D index showed significant improvement in both the PF (0.547?0.648, P < 0.0001) and the RF (0.507?0.648, P < 0.0001) cohorts. Similarly, total PHQ-9 improved significantly in the PF cohort (7.84?5.91, P < 0.001) and in the RF cohort (8.55?5.53, P = 0.02), as did total PDQ (PF: 77?63, P < 0.0001; RF: 85?70, P = 0.04). QOL scores were also compared between groups preoperatively and postoperatively. The only significant difference between PF and RF was observed in preoperative PDQ-Functional score (50 vs. 54, P = 0.04). The proportion of patients achieving an MCID was not significantly associated with cohort. Finally, perioperative cost did not differ significantly between cohorts (PF: $13,383 vs. RF: $13,595, P = 0.82). CONCLUSION RF patients had poorer preoperative PDQ-Functional scores, but both PF and RF produce significant improvement in all measures. There was no difference in QOL outcomes or cost between PF and RF. Therefore, while one procedure does not clearly have superior cost effectiveness than the other, both achieved significant effectiveness.

Comparison of Pain-reducing Effect After Selective Nerve Root Block According to the Type of Lumbar Foraminal Stenosis

2019 ◽  
Vol 32 (2) ◽  
pp. E60-E64 ◽  
Author(s):  
Sangbong Ko ◽  
Jaibum Kwon ◽  
Youngsik Lee ◽  
Seungbum Chae ◽  
Wonkee Choi
Keyword(s):  
Nerve Root ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Nerve Root Block ◽  
Selective Nerve Root Block

scholarly journals A less invasive surgery using a full-endoscopic system for L5 nerve root compression caused by lumbar foraminal stenosis

2018 ◽  
Vol 4 (3) ◽  
pp. 594-601
Author(s):  
Katsuhiko Ishibashi ◽  
Yasushi Oshima ◽  
Hirokazu Inoue ◽  
Yuichi Takano ◽  
Hiroki Iwai ◽  
...  
Keyword(s):  
Invasive Surgery ◽  
Nerve Root ◽  
Foraminal Stenosis ◽  
Nerve Root Compression ◽  
Less Invasive Surgery ◽  
Lumbar Foraminal Stenosis ◽  
Less Invasive

scholarly journals Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tae-Ha Lim ◽  
Soo Il Choi ◽  
Hyung Rae Cho ◽  
Keum Nae Kang ◽  
Chang Joon Rhyu ◽  
...  
Keyword(s):  
Facet Joint ◽  
Control Group ◽  
Foraminal Stenosis ◽  
Morphological Parameter ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Lumbar Foraminal Stenosis ◽  
Articular Process ◽  
Magnetic Resonance Imaging Mri ◽  
Bone Margin

Background. We devised a new morphological parameter called the superior articular process area (SAPA) to evaluate the connection between lumbar foraminal stenosis (LFS) and the superior articular process. Objective. We hypothesized that the SAPA is an important morphologic parameter in the diagnosis of LFS. Methods. All patients over 60 years of age were included. Data regarding the SAPA were collected from 137 patients with LFS. A total of 167 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of a routine medical examination. We analyzed the cross-sectional area of the bone margin of the superior articular process at the level of L4-L5 facet joint in the axial plane. Results. The average SAPA was 96.3±13.6 mm2 in the control group and 128.1±17.2 mm2 in the LFS group. The LFS group was found to have significantly higher levels of SAPA (p<0.001) in comparison to the control group. In the LFS group, the optimal cut-off value was 112.1 mm2, with 84.4% sensitivity, 83.9% specificity, and AUC of 0.94 (95% CI: 0.91–0.96). Conclusions. Higher SAPA values were associated with a higher possibility of LFS. These results are important in the evaluation of patients with LFS.

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