title: Partial facetectomy for lumbar foraminal stenosis.
abstract: Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms. Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes. Results. 27 of 47 patients (57%) reported no back pain and no functional limitations. Eight of 47 patients (17%) reported moderate pain, but had no limitations. Six of 47 patients (13%) continued to experience degenerative symptoms. Five of 47 patients (11%) required additional surgery. Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.
authors.affiliation: Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kang
authors.affiliation: Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USA.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Rodriguez-Olaverri
authors.affiliation: New York University Hospital for Joint Diseases, New York, NY 10016, USA.
authors.forename: Frank
authors.identifier: 0000-0003-2307-3037
authors.initials: F
authors.lastname: Schwab
authors.affiliation: Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USA.
authors.forename: Jenifer
authors.identifier: 0000-0003-4527-4462
authors.initials: J
authors.lastname: Hashem
authors.affiliation: Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USA.
authors.forename: Afshin
authors.initials: A
authors.lastname: Razi
authors.affiliation: Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USA.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Farcy
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