title: Technical considerations in transforaminal endoscopic spine surgery at the thoracolumbar junction: report of 3 cases.
abstract: OBJECTIVE In this study the authors describe the technical considerations and feasibility of transforaminal discectomy and foraminoplasty for the treatment of lumbar radiculopathy in patients who have herniated discs at the thoracolumbar junction. METHODS After institutional review board approval, charts from 3 consecutive patients with lumbar radiculopathy and T12-L1 herniated discs who underwent endoscopic procedures between 2006 and 2014 were reviewed. RESULTS Consecutive cases (n = 1316) were reviewed to determine the incidence and success of surgery performed at the T12-L1 level. Only 3 patients (0.23%) treated with endoscopic surgery for their herniated discs had T12-L1 herniated discs; the rest were lumbar or lumbosacral herniations. For patients with T12-L1 disc herniations, the average preoperative visual analog scale score was 8.3 (indicated in the questionnaire as describing severe and constant pain). The average 1-year postoperative visual analog scale score was 1.7 (indicated in the questionnaire as mild and intermittent pain). CONCLUSIONS Transforaminal endoscopic discectomy and foraminotomy can be used as a safe yet minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a thoracolumbar disc herniation.
authors.affiliation: Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and.
authors.forename: Albert E
authors.initials: AE
authors.lastname: Telfeian
authors.affiliation: Center for Pain Control, Brick, New Jersey.
authors.forename: Gabriele P
authors.initials: GP
authors.lastname: Jasper
authors.affiliation: Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and.
authors.forename: Adetokunbo A
authors.initials: AA
authors.lastname: Oyelese
authors.affiliation: Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and.
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005260:Female; D059526:Foraminotomy / Q000379:methods*; D006801:Humans; D055959:Intervertebral Disc Degeneration; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013904:Thoracic Vertebrae / Q000601:surgery; D064232:Visual Analog Scale
keywords: AP = anteroposterior; VAS = visual analog scale; endoscopic discectomy; minimally invasive; thoracolumbar; transforaminal