The article investigates a surgical technique called “radical decompression” for lumbar foraminal stenosis (LFS) at the L5-S1 segment. The study aims to prospectively assess instability and neurological improvement after the surgery. The patients were evaluated using the Japanese Orthopaedic Association (JOA) score and the JOA Back Pain Evaluation Questionnaire (JOABPEQ) before and two years after the surgery. Radiological parameters at L5-S1 were also measured. The results showed that the surgery resulted in good neurological recovery, improved JOA scores and JOABPEQ categories, and a low risk of postoperative segmental instability. No significant changes were observed in the radiological parameters. The study concludes that the surgical technique is effective for LFS at L5-S1, regardless of additional discectomy
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated spine centre in UK
Published article
CONCLUSIONS: Our surgical technique resulted in good neurological recovery and was associated with a low risk of postoperative segmental instability, regardless of additional discectomy.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Spine Surg. 2023 Sep 22;9(3):278-287. doi: 10.21037/jss-23-62. Epub 2023 Sep 19.ABSTRACTBACKGROUND: The highest incidence of lumbar foraminal stenosis (LFS) occurs in the L5-S1 segment and its anatomical features differ from those of other segments. Few previous reports have exhaustively assessed surgical outcomes after decompression surgery, limiting the materials to patients with LFS at the,
J Spine Surg. 2023 Sep 22;9(3):278-287. doi: 10.21037/jss-23-62. Epub 2023 Sep 19.
ABSTRACT
BACKGROUND: The highest incidence of lumbar foraminal stenosis (LFS) occurs in the L5-S1 segment and its anatomical features differ from those of other segments. Few previous reports have exhaustively assessed surgical outcomes after decompression surgery, limiting the materials to patients with LFS at the L5-S1 segment. We aimed to prospectively investigate instability and neurological improvement following our novel surgical technique for LFS at L5-S1, named “radical decompression” of the nerve root.
METHODS: Patients with foraminal stenosis at L5-S1 who underwent surgery using our technique were prospectively evaluated two years postoperatively. The Japanese Orthopaedic Association (JOA) score and the JOA Back Pain Evaluation Questionnaire (JOABPEQ) were evaluated preoperatively and two years postoperatively. The following radiological parameters at L5-S1 were measured: lateral translation, sagittal translation, the difference in sagittal translation (DST) between flexion and extension, disc wedging angle, lordotic angle, the difference in lordotic angle (DLA) between flexion and extension, and disc height. Pre- and postoperative data were compared using paired t-tests. In addition, the patients were classified into a disc group (Group D) and a non-disc group (Group ND) according to whether a discectomy was performed intraoperatively. Changes in each parameter before and after surgery were compared between the groups.
RESULTS: Twenty-eight patients were included in this analysis. The JOA scores improved in all patients. The mean preoperative and two-year postoperative JOA scores were 14.5±3.2 (range, 8-21) and 24.3±3.3 (range, 18-29), respectively (P<0.01). All JOABPEQ categories improved two years postoperatively (P<0.05). None of the patients underwent revision surgery. No significant changes were observed in any of the radiological parameters. No significant differences in the changes in each parameter before and after surgery were found between groups D and ND.
CONCLUSIONS: Our surgical technique resulted in good neurological recovery and was associated with a low risk of postoperative segmental instability, regardless of additional discectomy.
PMID:37841796 | PMC:PMC10570647 | DOI:10.21037/jss-23-62
The London Spine Unit : the highest rated spine centre in UK
Read the original publication:
Radical decompression without fusion for L5 radiculopathy due to foraminal stenosis
