Abstract
Introduction
Radiculopathy caused by foraminal nerve root compression is a common pathology of the lumbar spine. Surgical decompression through conventional open foraminotomy is the treatment of choice when surgery indicated. Minimally invasive tubular foraminotomy through a contralateral approach is a potentially effective treatment approach. The aim of this retrospective cohort study was to evaluate the efficacy and benefits of this approach for treatment of radiculopathy.
Materials and Methods
Patients with unilateral lower extremity radiculopathy, who underwent minimally invasive lumbar foraminotomy through tubular retractors via a contralateral approach between 2010 and 2012 were included. Oswestry disability index (ODI) and the visual analogue scale (VAS) for back, and leg pain were evaluated preoperatively, postoperatively, and at the latest follow-up. Functional outcome was evaluated using MacNab's criteria.
Results
For the total of 32 patients, postoperatively there was significant improvement in the ODI (p = 0.006), VAS back pain (p < 0.0001), and VAS leg pain on the pathology and the approach side (p = 0.004, p = 0.021, respectively). At follow-up of 12.3 ± 1.7 months, there was also significant improvement in the ODI (p < 0.0001), VAS back pain (p = 0.001), and VAS leg pain on the pathology and the approach side (p < 0.0001, p = 0.001, respectively). The functional outcome was excellent and good in 95.2%. One patient required fusion (3.1%).
Conclusion
A minimally invasive, facet-sparing contralateral approach is an effective technique for treatment of radiculopathy due to foraminal compression. It also allows for decompression of lumbar spinal stenosis and bilateral lateral recess decompression without the need for a fusion.
None declared