title: Clinical success of transforaminal endoscopic discectomy with foraminotomy: a retrospective evaluation.
abstract: 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. Visual Analog Scale was applied to each patient preoperatively and 6 months after the procedure.
  
  
  RESULTS
  Patients with multi-level pathologies receiving one procedure have an average relief of 69.7% attributed to correct diagnosis of the inflicting level as opposed to 83.9% improvement in patients with a single level herniation.
  
  
  CONCLUSIONS
  Patients with single level lumbar herniations receiving one endoscopic discectomy have excellent outcomes, but with a good response to a selective nerve root block as a preoperative adjunct, patients with multilevel disc herniations also have significant benefit from single level endoscopic discectomy.
authors.affiliation: Center for Pain Control, Brick, USA.
authors.forename: Gabriele P
authors.initials: GP
authors.lastname: Jasper
authors.forename: Gina M
authors.initials: GM
authors.lastname: Francisco
authors.forename: Albert E
authors.initials: AE
authors.lastname: Telfeian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery; D017586:Diskectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004724:Endoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D059526:Foraminotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D009407:Nerve Block; D059408:Pain Management; D010147:Pain Measurement; D012189:Retrospective Studies; D013126:Spinal Nerve Roots; D016896:Treatment Outcome; D055815:Young Adult
keywords: Endoscopic discectomy; Minimally-invasive; TESSYS; Transforaminal