Endoscopic Transforaminal Lumbar Foraminotomy: A Systematic Review and Meta-Analysis.
Endoscopy
Foraminal
Foraminotomy
Lumbar
Spine
Stenosis
Journal
Pain and therapy
ISSN: 2193-8237
Titre abrégé: Pain Ther
Pays: New Zealand
ID NLM: 101634491
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
24
06
2021
accepted:
13
08
2021
pubmed:
8
9
2021
medline:
8
9
2021
entrez:
7
9
2021
Statut:
ppublish
Résumé
Spinal endoscopic techniques have recently been applied to complex degenerative conditions or failed back surgery syndrome. We performed a systematic review and meta-analysis to assess transforaminal endoscopic lumbar foraminotomy (TELF) outcomes and adverse event rates. We also analyzed the effectiveness of the technique for chronic pain after arthrodesis or previous spinal surgery. Multiple databases were searched for studies published in the English language, involving patients > 18 years old who underwent endoscopic foraminotomy. Outcomes included the rate of patients who showed "excellent" and "good" postoperative improvement, decreased leg pain, and improved Oswestry Disability Index (ODI) scores. Adverse events considered in the analysis included nerve root damage and intraoperative dural tear, the proportion of patients requiring revision surgery or recurrences, and infections. A total of 14 studies, encompassing 600 patients, were identified. Approximately 85% of patients improved significantly after TELF, without significant differences among different groups (85% vs. 78%, respectively). Mean leg pain decreased an average of 5.2 points, and ODI scores improved by 41.2%. Patients with previous spine surgery or failed back surgery syndrome had higher postoperative leg dysesthesia rates after TELF (14% vs. 1%, respectively). TELF is a useful and safe method to achieve decompression in foraminal stenosis. This technique is indicated in the elderly or patients with comorbidities. Preoperative planning is paramount in determining the foraminal size and endoscope trajectory. A diamond burr is recommended because it has an advantage over the regular endoscopic shaver in bleeding control and complication avoidance.
Identifiants
pubmed: 34490586
doi: 10.1007/s40122-021-00309-1
pii: 10.1007/s40122-021-00309-1
pmc: PMC8586101
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1481-1495Informations de copyright
© 2021. The Author(s).
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