Clinical results of transforaminal full-endoscopic ventral facetectomy

for lateral recess stenosis

ISSLS 2021＠online #2659

The presenting author has no financial COI to disclosure concerning the presentation.

full-endoscopic ventral facetectomy (FEVF)

transforaminal approach local anesthesia

postoperative results of TF-FEVF

predictor of FEVF`s poor outcome

• 85 TF-FEVF for LRS

MRI• Disc degeneration• Endplate degeneration• Disc height• Ligamentum flavum thickening

flexion-extension radiograph• sagittal translation• sagittal angulation• cobb angle (+:convex side)

CT• bony stenosis

Patient character• Age• Sex• Diagnosis(with/without disc bulge)

• Operated level• History of spinal surgery

• modified Macnab criteria• VAS(Low Back Pain, Leg Pain, Numbness)• JOABPEQ

HRQOL

Preoperative, final F/U(>3M)

Clinical evaluation items

Image evaluation items

Operated level 85 cases ％

L2/3 3 3.5

L3/4 12 14.1

L4/5 64 75.3

L5/Ｓ 6 7.1

diagnosis 85 cases ％

RLS 43 50.6RLS with disc bulge 42 49.4

Modic type 85 cases %

none 47 55.3

1 29 33.6

2 5 6.0

3 4 4.8

Pffirrmann grade 85 cases %

grade1 0 0

grade2 0 0

grade3 3 3.5

grade4 63 74.1

grade5 19 22.4

Average age:70.5 (47-90)male:47 female:38Average F/U：14.8M (3-36)

modified Macnab criteria

（n:85）

Open surgery Tube-type endoscopic surgery Full-endoscopic spine surgery

(Ruetten S, JNS, 2009)(Lee CW, Biomed Res Int, 2019)(Sairyo K, J. med. Invest., 2017)

Possible under local anesthesia

・Interlaminar ・Transforaminal

conclusion

large sagittal angulation large sagittal translation concave side